盐酸戊乙奎醚对下肢手术患者松止血带后血清白细胞介素-6和肿瘤坏死因子-α仪浓度的影响

Effect of penehycHdine hydrochloride on serum interleukin-6 and tumor necrosis factor-alpha concentrations following tourniquet deflation in patients undergoing lower limb surgery

目的观察盐酸戊乙奎醚预先给药对下肢手术患者松止血带后血清白细胞介素．6（IL-6）和肿瘤坏死因子．d（TNF-α）浓度的影响。方法择期行单侧下肢手术且术中应用止血带患者30例，ASA分级I一Ⅱ级，将患者按随机数字表法分为对照组和研究组，每组15例。麻醉前30min，研究组静脉滴注盐酸戊乙奎醚0．01—0．02mg／ks，对照组静脉滴注相应体积的0．9％氯化钠。于止血带充气前即刻（T0）、松止血带前即刻（T1）、松止血带后30min（T2）、松止血带后60rain（T3）抽取非患侧肢体外周静脉血，采用酶联免疫吸附法测定血清IL-6和TNF-α的浓度。结果两组松止血带后相同时间点血清TNF—d变化量比较差异无统计学意义（P〉0．05）；研究组松止血带后各时间点血清IL-6浓度均较T0下降，对照组均较T0上升，研究组与对照组T3与T0的血清IL-6浓度差比较差异有统计学意义[（一8．84±5．6）ng／L比（10．24±6．7）ng／L，P〈0．05]结论盐酸戊乙奎醚预先给药能够降低下肢手术患者松止血带后血清IL-6浓度。

Objective To observe the effect of penehyclidine hydrochloride （PHC） on serum interleukin-6 （IL-6） and tumor necrosis factor-alpha （TNF-ct ） concentrations following tourniquet deflation in patients undergoing lower limb surgery. Methods Thirty adult patients,scheduled for unilateral lower limb surgery, ASA classification I - 1I grades, were divided into control group and research group by random number table,each group of 15 cases. Before anesthesia 30 rain, PHC in intravenous infusion of 0.01-0.02 mg/kg in research group, the corresponding volume in intravenous infusion of 0.9% sodium chloride in control group. Peripheral venous blood samples were collected immediately before tourniquet inflation （T0,baseline） ,immediately before tourniquet deflation （T1）, 30 min （T2） and 60 min （1＂3） after tourniquet deflation. Serum IL-6 and TNF- ~t concentrations were measured by enzyme linked immunosorbent assay. Results Serum TNF- ot change at the same time point after tourniquet deflation was not statistically significant between two groups （P 〉 0.05 ）. Serum IL-6 concentration was decreased at each time point after tourniquet deflation compared with To in research group,while increased in control group. Serum IL-6 concentration difference of I＂3 and To had statistically significant between research group and control group[ （-8.8 ~ 5.6） ng/L vs. （ 10.2 ＋ 6.7 ） ng/L, P 〈 0.05 ]. Conclusions PHC in advance can decrease serum IL-6 concentration after tourniquet deflation in patients undergoing lower limb surgery.