黄芪注射液对腹腔镜手术患者围术期T淋巴细胞免疫的影响

Effect of astragalus injection on T cell immunity of patients undergoing laparoscopic surgery during perioperative period

目的:探讨黄芪注射液对腹腔镜手术患者围术期T淋巴细胞免疫功能的影响。方法:40例择期全麻下行腹腔镜手术的不孕症患者,随机分成黄芪注射液组和对照组。注射组静滴黄芪注射液10 ml+生理盐水90 ml,15 min滴完后静注芬太尼、丙泊酚、顺式阿曲库铵行气管插管控制呼吸,术中以丙泊酚及七氟醚维持麻醉,维持生命体征在正常水平,术毕前腹腔冲洗液加入黄芪注射液10 ml。对照组静滴生理盐水100 ml后麻醉,腹腔冲洗液中不加黄芪注射液,余同注射组。采集手术前(T0)、术毕(T1)、术后1天(T2)、术后3天(T3)的静脉血,流式细胞仪测定T淋巴细胞亚群(CD3+、CD4+、CD8+)的水平,计算CD4+/CD8+比值。结果:与T0时比较,对照组CD3+、CD4+水平及CD4+/CD8+比值在T1、T2时均明显下降,T3时才基本恢复T0时水平,注射组上述指标在T1时下降,但T2时已恢复T0时水平,两组CD8+水平在T1、T2、T3时均无明显变化;组间比较,T2、T3时两组CD3+、CD4+水平及CD4+/CD8+比值均有统计学差异,注射组高于对照组,CD8+水平两组间无统计学差异。结论:对照组术后T淋巴细胞亚群水平相对注射组明显下降,表明黄芪注射液在腹腔镜手术的应用对T淋巴细胞的免疫功能具有一定的保护作用。

Objective：To explore the effect of astragalus injection on T cell immunity of patients undergoing laparoscopic surgery during perioperative period.Methods：Forty infertile patients undergoing laparoscopic surgery under general anesthesia were selected and randomly divided into astragalus injection group and control group.The patients in astragalus injection group were treated with intravenous drip of astragalus injection（10 ml） and normal saline（90 ml） within 15 minutes,then fentanyl,propofol,and cisatracurium were injected intravenously to control respiration by tracheal intubation,during operation,propofol and sevoflurane were used to maintain anesthesia and vital signs at normal levels,before the end of operation,10 ml astragalus injection were added into peritoneal washes.The patients in control group were anaesthetized after intravenous drip of 100 ml normal saline,astragalus injection was not added into peritoneal washes,the other treatments were the same as those used in astragalus injection group.The venous blood samples before operation（T0）,at the end of operation（T1）,at one day（T2） and three days（T3） after operation were collected,flow cytometry was used to detect the levels of subgroups of T cells（CD3＋,CD4＋,and CD8＋）,the ratio of CD4＋/CD8＋ was calculated.Results：Compared with at T0,the levels of CD3＋,CD4＋,and the ratio of CD4＋/CD8＋ in control group decreased significantly at T1 and T2,then the levels returned to those at T0 until T3;in astragalus injection group,the above-mentioned indexes decreased at T1,but at T2,the levels returned to those at T0,there was no significant difference in the levels of CD8＋ at T1,T2,and T3 between the two groups;the levels of CD3＋,CD4＋,and the ratio of CD4＋/CD8＋ at T2 and T3 in astragalus injection group were significantly higher than those in control group;there was no significant difference in the level of CD8＋ between the two groups.Conclusion：After operation,the levels of subgroups of T cells in astragalus injection group were significantly lower than those in control group,which indicates that astragalus injection used for laparoscopic surgery plays a certain protective role in T cell immunity.