术前静脉注射氯诺昔康对子宫切除术患者血浆趋化因子表达的影响

EFFECTS OF INTRAVENOUS INJECTION OF LORNOXICAM BEFORE HYSTERECTOMY ON EXPRESSION OF CHEMOKINE IN BLOOD PLASMA

目的:研究术前静脉注射氯诺昔康对围术期病人血浆趋化因子表达的影响。方法:择期行子宫切除术病人30例,静注氯诺昔康8或16mg。在开放静脉前(T0)、手术切皮后30min(T1)、手术结束时(T2)、术后24h (T3)和术后48h(T4)采集静脉血,测定血浆依赖激活正常T细胞表达分泌调节蛋白(RANTES)、基质细胞源性因子-1(SDF-1α)和单核细胞趋化蛋白-1(MCP-1)浓度。结果:手术和麻醉引起的创伤可导致子宫切除术病人围手术期血浆趋化因子RANTES表达下降,MCP-1及SDF-1α表达增加,氯诺昔康可以逆转这一变化。结论:氯诺昔康有助于维持子宫切除术病人围术期细胞免疫功能的稳定。

It is well documented that surgery is characteristi- cally associateed with a systemic inflammatory response, which is initiated by the synthesis of various cytokines, including tumor necrosis factor(TNF),interleukin-1, interleukin-6 and interleukin-8.Inflammatory cytokines, endothelial activation and endothelial-leukocyte interactions have been reported to play an important role in the induc- tion of systemic inflammatory response syndrome,caus- ing large fluid shifts,coagulation disturbances and increased concentrations of catecholamines and stress hormones. Recently,the chemokines,a group of cytokines with chemotactic and activating effects on leukocytes,have been identified as important mediators in both acute and chronic human inflammatory disorders.Theα- chemokines,notably interleukin-8,induce neutrophil chemotaxis,whereas the chemokines are chemotactic for monocytes and T-cell subsets.Among theβchemokines, monocyte chemoattractant protein(MCP-1) and regulated- upon-activation normal T-cell expressed and secreted (RANTES)attract and activate monocyte-macrophages and polymorphonuclear neutrophils^([2-3]).We will study on the effect of intravenous injection of lornoxicam before hysterectomy on expression of chemokine during perioperative period.