瑞芬太尼和异丙酚对健康成人静脉血中性粒细胞CD11b表达的影响

Effects of remifentanil and propofol on the CD11b expression of polymorphonuclear leukocytes of healthy adults

目的探讨瑞芬太尼和异丙酚对健康成人静脉血中性粒细胞（PMNs）CD11b表达的影响。方法取成人静脉血，采用正交实验设计确立实验因素为瑞芬太尼和异丙酚；实验水平数为5水平，即瑞芬太尼空白对照、溶媒（甘氨酸）对照、5ng／ml、50ng／ml、500ng／ml和异丙酚空白对照、溶媒（脂肪乳）对照、5μg／ml、50μg／ml、500／μg／ml，用正交表L25（5^6），观察药物对静息状态和脂多糖（LPS）激活状态PMNs下CD11b表达的影响，对激活状态的PMNs根据用药时机的不同又分为预防性用药和治疗性用药。预防性用药加入药物后1h用终浓度为1μg／ml的LPS进行刺激；治疗性用药在LPS刺激后1h加药。各标本均放入37℃、95％的空气-5％的CO2培养箱中孵育3h，其间每隔1h混匀1次。用流式细胞仪测定PMNs CD11b表达。结果瑞芬太尼和异丙酚对静息状态PMNs CD11b的表达无影响。预防性用药对PMNs CD11b表达的比较：与空白对照比较，5、50、500ng／ml瑞芬太尼可上调激活状态PMNs CD11b表达（P〈0．05或0．01）；与甘氨酸对照比较，50、500ng／ml瑞芬太尼可上调激活状态PMNs CD11b表达（P〈0．05和0．01）；异丙酚对激活状态PMNs CD11b表达无影响。治疗性用药对PMNs CD11b表达的比较：与空白对照和甘氨酸对照比较，500ng／ml瑞芬太尼可上调激活状态PMNs CD11b表达（P〈0．01）；与空白对照比较，50ng／ml异丙酚可上调激活状态PMNs CD11b表达（P〈0．05）。结论瑞芬太尼和异丙酚对PMNs的CD11b表达的影响可能与PMNs所处的状态、用药剂量以及用药时机有关。

Objective To study the effects of remifentanil and propofol on the CD11b expression of polymorphonuclear leukocytes （PMNs） of healthy adults in vitro. Methods Venous whole blood was obtained from healthy donors of both sexes aged 20-40 yrs and anticoagulated with EDTA. The experiment was divided in 2 parts ： remifentanil and propofol. Each part was divided into 5 groups： Each group was again divided into static group and LPS group and the latter was further divided into drug-pretreated group and drug-treated group. Blood samples were incubated with the drug for 3 h at 37℃ in 95% air-5% CO2 . 80 μl of anti-human FITC-CD11b mono-clone antibodies were added to 200 μl of each sample which was incubated for 45 min on ice in the dark. Then 4.0 ml of FACSIyse was added to each sample to break down RBC. The pellet was resuspended in 500 μl of phosphate-buffered saline （PBS） after centrifugation and CD11b expression of PMNs was determined using flow cytometry. Results （1） Remifentanil and propofol had no effect on the CD11b expression of PMNs in static state. （2） In drug-pretreated group remifentanil 5, 50 and 500 ng· ml^-1 significantly upregulated the CD11b expression of LPS-activated PMNs as compared with control groups while propofol had no effect on CD11b expression of LPS-activated PMNs. （3） In drug-treated group only remifentanil 500 ng·ml^-1 and propofol 50 μg· ml^-1 significantly upregulated CD11b expression of LPS-activated PMNs as compared with control groups. Conclusion The effects of remifentanil and propofol on CD11b expression of PMNs are closely related to the state of PMNs （static or activated） ,dose of the drugs and the occasion when the drugs are used.