术前静注氯诺昔康对子宫切除术病人围术期单核细胞趋化蛋白-1表达的影响

The effect of intravenous injection of lornoxicam before hysterectomy on expression of monocyte chemotactic protein-1 during perioperative period

目的探讨术前静注氯诺昔康对子宫切除术病人围术期单核细胞趋化蛋白-1表达的影响。方法择期行子宫切除术的病人30例,随机分为3组,对照组、氯诺昔康8 mg组、氯诺昔康16 mg组,每组各10例。氯诺昔康8 mg组在开放静脉后静脉注入氯诺昔康8 mg,氯诺昔康16 mg组在开放静脉后静脉注入氯诺昔康16 mg。分别在开放静脉前、手术开始后30 min、手术结束、术后24 h、术后48 h外周静脉采血4 ml测定血浆单核细胞趋化蛋白-1(MCP-1)浓度。结果①三组病人的血浆MCP-1水平在手术开始后升高,到手术结束达到高峰,分别为(76±16)μg/L、(46±7)μg/L和(47±10)μg/L,与开放静脉前比较差异有统计学意义(P<0.05);②氯诺昔康8 mg组在手术结束时和术后24 h血浆MCP-1水平为(46±7)μg/L和(30±7)μg/L与对照组比要低(P<0.05),氯诺昔康16 mg组在手术结束时和术后24 h血浆MCP-1水平为(47±10)μg/L和(32±6)μg/L与对照组比要低(P<0.05);③氯诺昔康8 mg组和16 mg组比较对血浆MCP-1水平影响差异无统计学意义。结论术前静注氯诺昔康8 mg和16 mg可以有效的抑制子宫切除病人围术期MCP-1的表达的增加,16 mg组并不优于8 mg组,术前静注氯诺昔康有助于维持子宫切除病人围术期的免疫功能稳定。

Objective To investigate the effect of intravenous injection of lornoxicam before hysterectomy on expression of monocyte chemotactic protein - 1 during perioperatlve period. Methods Thirty patients undergoing elective hysterectomy were divided ran- domly into 3 groups （ n = 10 each） ; control group （group I） ,intravenous injection of lornoxicam 8 mg before hysterectomy （group Ⅱ） , and intravenous injection of lornoxicam 16 mg before hysterectomy （group Ⅲ）. Venous blood samples were taken before anesthesia, at the beginning of 30 min after operation, at the end of operation and at 24 h and 48 h after operation, respectively. Monocyte chemotactic protein - 1 levels （ MCP - 1 ） were detected by enzyme linked immunosorbent assay in plasma. Results MCP - 1 levels increased after the beginning of operation and reached its peak value after operation. The peak values were （76 ±16 ） μg/L, （46 ± 7 ） μg/ L and （47 ± 10） μg/L, respectively. MCP - 1 levels were （46 ±7） μg/L and （30 ±7） μg/L at the end of operation and at 24 h after operation in lornoxicam 8 mg group, significantly lower than those in control group（ P 〈 0.05 ）, respectively. MCP - 1 levels were （47 ±10） μg/L and （32 ±6） μg/L at the end of operation and at 24 h after operation in lornoxicam 16 mg group, significantly lower than those in control group too（P 〈0.05 ）, respectively. There was no difference between lornoxicam 8 mg group and lornoxicam 16 mg group. Conclusion Intravenous injection of lornoxicam before hysterectomy can decrease the immune response of expression of MCP - 1. Intravenous injection of lornoxlcam 16 mg before hysterectomy has no advantage over 8 rag. MCP - 1 is a sensitive marker to evaluate the immune function of patients.