氟比洛芬酯超前镇痛对直肠癌根治术患者血浆IL-6和胰岛素抵抗的影响

Effects of preemptive analgesia of flurbiprofen axetil on interleukin-6 and insulin resistance in patients undergoing radical resection of rectal carcinoma

目的研究氟比洛芬酯超前镇痛对直肠癌患者血浆白细胞介素6(IL-6)和胰岛素抵抗的影响。方法直肠癌择期手术患者30例,随机分为氟比洛芬酯组(F)和对照组(C),分别于麻醉前(T0)、手术开始后2h(T1)、术后第6h(T2)检测静脉血糖(BG)、血胰岛素(Ins)、IL-6,并计算胰岛素抵抗指数(IRI)。结果两组T1和T2时的BG、Ins、IL-6水平和IRI都较T0明显增加(P<0.05),但F组患者T1、T2时的BG、Ins、IL-6水平和IRI均低于C组(P<0.05)。结论直肠癌手术患者术中和术后有BG、Ins和IL-6水平升高,胰岛素抵抗增加。氟比洛芬酯超前镇痛可减轻这些变化。

Objective To study the effects of preemptive analgesia of flurbiprofen axetil on interleukin-6（IL-6） and insulin resistance in patients undergoing radical resection of rectal carcinoma.Methods Thirty patients undergoing radical resection of rectal carcinoma were randomly assigned into two groups of F（flurbiprofen axetil 1 mg/kg） and C（normal saline 10 ml） with 15 cases each.The drugs were intravenously injected at 15 min before surgery.Plasma levels of IL-6,blood glucose（BG） and insulin were determined before anesthesia（T0）,at 2 h during surgery（T1） and 6 h after operation（T2）.Insulin resistance index（IRI） was calculated with homeostasis model assessment （HOMA-IR）.Results Plasma levels of IL-6,BG,insulin and IRI were all higher at T1 and T2 than those at T0 in two groups（P〈0.05）,which were lower in group F than those in group C at T1 and T2（P〈0.05）.Conclusion Plasma levels of IL-6,BG and insulin are increased with an increase of insulin resistance in patients undergoing radical resection of rectal carcinoma,which may be attenuated by preemptive administration of flurbiprofen axetil.