七氟醚、异氟醚对肺癌根治术患者围术期血清中IL-6、TNF-α及sIL-2R浓度的影响

The effect of sevoflurane and isoflurane on the serum concentrations of IL-6,TNF-α and sIL-2R of patients undergoing lung cancer radical surgery during perioperative period

目的本实验通过对肺癌根治术患者围手术期多种细胞因子的血清浓度进行检测与分析,探讨常用吸入性麻醉剂对肺癌患者围手术期免疫功能的影响,为临床麻醉药物的选择提供理论依据。方法选择预实施肺癌根治术患者44例,随机分为七氟醚(SEV)组和异氟醚(ISO)组;利用酶联免疫吸附法(ELISA)检测及分析两组患者围术期不同时间点血清中白介素-6(IL-6)、肿瘤坏死因子α(TNF-α)、可溶性白介素2受体(sIL-2R)的浓度。结果两组患者相比,SEV组患者在手术结束(T2)时血清IL-6浓度明显低于ISO组(P<0.05);SEV组血清TNF-α浓度在术后24 h(T3)明显低于ISO组(P<0.05);两组患者的sIL-2R血清浓度在围术期的变化趋势基本一致,无显著性差异(P>0.05)。结论两种吸入性麻醉剂相比,七氟醚的使用可能对于肿瘤患者术后免疫功能的恢复更具有积极意义,在肺癌根治术中麻醉药物选择上更具有优势。

Objective To detect and analyse of serum concentrations of cytokines of patients undergoing lung cancer radical surgery during perioperative period to explore how the commonly used inhaledanesthetics effect the immune function of these patients,in order to provide a theoretical basis for the choice of drugs of clinical anesthesia.Methods 44 patients undergoing lung cancer radical surgery were selected and randomly divided into group sevflurane（SEV,n=22）,group isoflurane（ISO,n=22）.The serum concentrates of IL-6,sIL-2R and TNF-α were detected and analysed at different time points by enzyme linked immunosorbent assay（ELISA）.Results The serum IL-6 in group SEV was significantly lower after operation（T2） than that of group ISO（P0.05）;The concentration of serum TNF-α from group SEV was significantly lower at 24 h after surgery（T3） than that of group ISO（P0.05）;There was no difference of slL-2R level between group SEV and ISO at corresponding points.Conclusion The affection of sevoflurane is smaller on the immune functions of patients undergoing radical surgery for lung cancer than isoflurane.