帕瑞昔布钠预先镇痛对乳癌根治术患者免疫功能的影响

Effects of pre-emptive analgesia with parecoxib sodium on immunity in patients after radical operation of breast cancer

目的 探讨帕瑞昔布钠预先镇痛对乳癌患者免疫功能的影响.方法 乳癌改良根治术患者40例,随机分为两组：每组20例,麻醉前Ⅰ组静脉注射帕瑞昔布钠40 mg;Ⅱ组静脉注射生理盐水5 ml.观测麻醉前20 min（T0）,麻醉后30 min（T0.5）、4 h（T4）、24 h（T24）时静脉血淋巴细胞总数、T细胞亚群标志细胞数.结果 Ⅰ组T4、T24时的CD3＋、CD4＋、CD8＋标志细胞数以及淋巴细胞总数与T0时相比均减少（P〈0.05）.Ⅱ组T0.5、T4、T24时的CD3＋、CD4＋、CD8＋标志细胞数以及淋巴细胞总数与T0时相比亦均显著减少（P〈0.05）,T24时的CD3＋、CD4＋、CD8＋标志细胞数以及淋巴细胞总数与T0.5时相比亦显著减少（P〈0.05）.T0.5、T4时,Ⅰ组的CD3＋、CD4＋、CD8＋标志细胞数以及淋巴细胞总数均高于Ⅱ组（P〈0.05）.结论 帕瑞昔布钠预先镇痛可以减轻手术及麻醉对于乳腺癌患者免疫功能的抑制,对乳腺癌患者免疫系统具有一定保护作用.

Objective To evaluate the pre-emptive analgesia effects of parecoxib sodium on immunity in patients with breast cancer after operation. Methods Forty patients with breast cancer were randomly divided into two groups. In group Ⅰ （n=20） patients received iv parecoxib sodium before anesthesia. In group Ⅱ（n = 20） patients received iv normal saline as control. Peripheral venous blood samples were collected 20 rain before anesthesia （T0）, 30 rain postoperatively（T0.5）, 4 hrs postoperatively （T4）, and 24 hrs postoperatively （T24） for the determination of CD3＋ , CD4＋ , CD8＋ and lymphocytes measured by flow cytometry. Results The CDa＋ , CD4＋ , CDa＋ and lympho cytes were decreased at T0.5, T4, T24 compared with those at To in group Ⅱ （P〈0.05） ; The CDs＋ , CD4＋ , CDs＋ and lymphocytes were decreased at T24 compared with those at T0.5 in group Ⅱ （P〈 0.05） . The CD3＋ , CD4＋ , CDs＋ and lymphocytes were decreased at T4, T24 compared with those at To in group Ⅰ （P〈0.05）o The CD3＋ , CD4＋ , CD8＋ and lymphocytes in group Ⅰ were higher than those in group Ⅱ at T0. 5 and T4 （P〈0.05）. Conclusion Pre-emptive analgesia of parecoxib sodium has a positive effect on alleviating immunosuppression induced by surgery and anesthesia, thus it may protect the immune system in patients with breast cancer during operation.