针药复合麻醉对心脏手术病人IFN-γ、IL-2、IL-6和IL-10的影响

Changes of IFN-γ,IL-2,IL-6 and IL-10 in the patient with cardiac surgery under combined acupuncture anesthesia

目的:观察电针对心脏手术病人细胞因子的影响,并对针药复合麻醉用于心脏手术予以评价。方法:选择房间隔缺损修补术30例,分为全麻组(A组)、针麻组(B组)和全麻复合电针组(C组)。分别于麻醉前、转流前、停转流后30min和术后24h采集外周静脉血,测定细胞培养上清液中干扰素-γ(IFN-γ)、白细胞介素-2(IL-2)、IL-6和IL-10的水平。结果:IFN-γ和IL-2水平于停转流后三组均降低;术后24h,各组进一步降低,但C组明显高于B组。IL-6和IL-10水平于术后24h三组均显著升高,但组间比较差异无显著性意义。结论:全麻复合电针不能完全改善体外循环(CPB)引起的IL-2、IFN-γ抑制,但要好于全麻和针麻,提示全麻复合电针对应激反应的良好控制可部分改善CPB引起的免疫功能抑制。针刺对体外循环心脏手术引起的炎性细胞因子反应无影响。

Objective To observe the effect of electroacupuncture（EA） on cytokines in the cardiac surgical patient and to evaluate the application of combined acupuncture anesthesia to cardiac surgery. Methods Thirty patients with atrial septal defect were divided into 3 groups, general anesthesia group （A）, acupuncture anesthesia group （B） and combined general anesthesia and EA group （C）. Peripheral blood samples were collected before anesthesia, before cardiopulmonary bypass （CPB）, 30 rain after CPB and 24 h after operation to determine the levels of interferon-γ（IFN-γ）, interleukin-2 （IL-2）, IL-6 and IL-10. Results The levels of IFN-T and IL-2 decreased in the 3 groups after CPB and further decreased 24 h after operation, and in the group C were higher than those in the group B. The levels of IL-6 and IL-10 significantly increased 24 h after operation in the 3 groups with no significant difference among the 3 groups. Conclusion The general anesthesia combined with EA can not completely improve the decrease of IFN-γ and IL-2 induced by CPB, indicating that the good response of the general anesthesia combined with EA to stress can partially improve the immunosupression induced by CPB. Acupuncture does not have significant effect on inflammatory cytokine reaction induced by cardiac surgery.