高乌甲素对上腹部手术患者免疫球蛋白水平的影响

Effect of lappaconitine on immunoglobulin levels of patients with upper abdominal surgery

目的 探讨高乌甲素（LA）对上腹部手术患者IgA、IgM、IgG水平的影响.方法 选择行上腹部手术患者36例,随机数字表法分为3组,高乌甲素组、曲马多组、空白对照组,每组12例.高乌甲素组、曲马多组术前30 min分别静脉滴注高乌甲素8 mg、曲多马100 mg,30 min滴注完毕.麻醉后即开始在高乌甲素组、曲马多组连接电子输注泵,以高乌甲素0.28 mg/ml或曲马多8 mg/ml进行持续背景输注,术后再实施经皮颈动脉血管造影.分别于麻醉用药前30min、术毕即刻、术后24 h、术后48 h取外周静脉血,测定IgA、IgM、IgG.结果 术后48 h空白对照组血清IgA为（1.72±0.27）g/L,与高乌甲素组（1.96±0.36）g/L比较差异有统计学意义（P＜0.05）;术后24 h空白对照组、曲马多组血清IgM分别为（1.32±0.18）、（1.40±0.20）g/L,较术组麻醉用药前降低,与高乌甲素组（1.60±0.23）g/L比较差异有统计学意义（P＜0.05）;空白对照组术毕即刻、术后24 h血清IgG降低,与高乌甲素组比较差异有统计学意义（P＜0.05）.结论 观察患者不同时段IgA、IgM、IgG的水平,发现高乌甲素于上腹部手术后在一定程度上可稳定血清IgA、IgM、IgG水平.

Objective To detect lappaconitine（LA） effect on the levels of IgA, IgM, IgG in upper abdominal surgery patients. Methods Thirty-six patients with upper abdominal surgery were randomized in to 3 groups with 12 in each group（ LA group, the tramadol group and the placebo group）. Patients in LA group and tramadol group received intravenous drop of LA 8 mg and tramadol 100 mg in 30 min, then received background pump supply of LA 0.28 mg/ml or tramadol 8 mg/ml, and PCA was conducted postoperatively. Peripheral venous blood was taken （30 min before anesthesia, immdiately after the hemorrhoid operation and at postoperative 24th 48th h）for IgA,IgM and IgG examination. Results IgA level in the placebo group was much lower at postoperative 48 h than that in the LA group（P〈0.05）;IgM level was much lower in placebo group and tramadol group at 24 h than that in LA group（P〈0.05）. The IgG level immediately after operation and at the postoperative 24th h in placebo group was much lower than that in LA group （P〈0.05）. Conclusion Lappaconitine can stabilize IgA, IgM and IgG levels after upper abdominal surgery.