地佐辛和吗啡对胃肠道肿瘤患者术中免疫功能的影响

发布时间：2018-04-03 15:16

本文选题：地佐辛　切入点：吗啡　出处：《中国医院药学杂志》2015年17期

【摘要】：目的:比较地佐辛和吗啡对胃肠道肿瘤患者术中T淋巴细胞群和NK细胞数量的影响。方法:60例胃肠道肿瘤行根治手术的患者,随机数字表法随机分为地佐辛(D)组和吗啡(M)组。D组麻醉前肌注地佐辛1 mg·kg-1,M组麻醉前肌注吗啡1 mg·kg-1。分别在麻醉前、手术1 h、术毕、术后1 h抽取患者外周静脉血,用流式细胞仪检测T淋巴细胞亚群(CD3+、CD3+CD4+、CD3+CD8+)、活化T细胞(CD3+HLA-DR+)和自然杀伤(NK)细胞(CD3-CD16+CD56+)数量的变化。术后随访观察、记录2组患者VAS评分及不良反应。结果:2组患者手术1 h时点CD3+、CD3+CD4+、CD3+CD4+/CD3+CD8+、CD3+HLA-DR+、NK细胞数量较麻醉前相比明显下降,M组各细胞数量在此时点明显低于D组。术毕和术后1 h 2组各细胞数量有所回升,但M组明显低于D组和麻醉前水平。2组患者VSA评分无显著差异(P0.05)但D组术后不良反应发生率较M组低(P0.05)。结论:地佐辛对胃肠道肿瘤患者术中T淋巴亚群和NK细胞抑制作用较吗啡小。
[Abstract]:Aim: to compare the effects of dizosin and morphine on T lymphocyte group and NK cell count in patients with gastrointestinal cancer.Methods Sixty patients with gastrointestinal cancer undergoing radical operation were randomly divided into two groups: dizosin group (D) and morphine group (group M). Group D was intramuscularly injected with dizosin 1 mg kg -1 before anesthesia and group M was given morphine 1 mg kg -1 before anesthesia.The peripheral venous blood was extracted before anesthesia, 1 hour after operation and 1 hour after operation. The changes of CD3-CD16 CD56 were detected by flow cytometry in T lymphocyte subsets (CD3 CD4, CD3 CD8, activated T cell CD3 HLA-DR) and natural killer (NK) cells.VAS scores and adverse reactions were recorded in two groups.Results at 1 h after operation, the number of CD3 CD4 / CD3 CD8 CD3 HLA-DR NK cells in CD3 CD4 / CD3 CD8 in group M was significantly lower than that in group D at 1 h after operation.At the end of operation and 1 hour after operation, the number of cells increased, but the VSA score in group M was significantly lower than that in group D and group 2 before anesthesia (P 0.05). However, the incidence of adverse reactions in group D was lower than that in group M (P 0.05).Conclusion: the inhibitory effect of dizosin on T lymphoid subsets and NK cells in patients with gastrointestinal neoplasms is less than that of morphine.
【作者单位】：华中科技大学同济医学院附属襄阳市中心医院麻醉科;
【分类号】：R969

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