丙泊酚麻醉对肝癌射频消融术患者血清白介素和HSP70水平的影响

Effects of propofol anesthesia on serum interleukins and HSP70 levels in patients with liver cancer after radiofrequency ablation

目的:探讨丙泊酚全身麻醉对肝癌射频消融术患者血清白介素(IL)-6、8、10和热休克蛋白70(HSP70)水平的影响。方法:择期行肝癌射频消融术的患者40例,分成2组施术,每组20例。观察组患者在全麻诱导后应用丙泊酚和瑞芬太尼维持麻醉,对照组患者在穿刺部位利多卡因局部阻滞麻醉。术中检测麻醉前、首次穿刺成功时,热封闭针道时,术后1h、24h和48h时的平均血压、心率、脉搏血氧饱和度和体温;采集患者术前,术后1、24和48h静脉血5mL,ELISA法测定血清IL-6、IL-10、IL-8及HSP70。结果:2组患者术中和术后体温、血压均升高,但观察组变化幅度小于对照组(体温:F组间=14.568,F时间=291.525,F交互=13.655,P均<0.001;血压:F组间=23.372,F时间=14.007,F交互=25.795,P均<0.001)。2组术后血清IL-6、8、10及HSP70水平亦较术前升高(F时间分别为48.793、53.721、25.970和24.779,P均<0.001),而观察组L-6、8和HSP70升高幅度小于对照组(F组间=31.953、59.836和20.479,P均<0.001)。结论:丙泊酚麻醉可减轻肝癌射频消融术患者的伤害性炎性反应。

Aim：To study the effects of propofol anesthesia on serum interleukins（IL） and HSP70 levels in patients with liver cancer after radiofrequency ablation（RFA）.Methods：Forty ASA Ⅰ ～ Ⅱ patients with liver cancer aged 40 ～ 65 years would receive RFA were divided into 2 groups（20 in each group）.Patients in group P were given propofol to maintain general anesthesia.Patients in group C were given lidocaine to maintain local anesthesia.MBP,HR,SPO2,and temperature were detected at the time of pre-anesthesia,post-anesthesia,heat blocking action,and 1,24 and 48 h after therapy.In addition,serum IL-6,IL-8,IL-10 and HSP70 levels were determined before therapy and at 1,24,and 48 h after therapy by ELISA.Results：The temperature,MBP,and serum HSP70,IL-6,IL-8,IL-10 levels of the two groups increased during RFA（Ftime =291.525,14.007,24.779,48.793,53.721,and 25.970,P〈0.001）,but the changes of group C was more obvious than group P（P 〈 0.001）.Conclusion：Propofol anesthesia can effectively restrain the damaged inflammatory reaction in patients with liver cancer after RFA.