帕瑞昔布钠切皮前给药对胃癌根治术患者细胞免疫功能的影响

Effects of pre-incisional with parecoxib sodium on cellular immune function in patients undergo radical resection of gastric carcinoma

目的帕瑞昔布钠切皮前给药对胃癌根治术患者细胞免疫功能的影响。方法择期行胃癌根治术患者40例,ASAⅡ～Ⅲ级,随机分为镇痛组(A组)和对照组(B组),每组20例。A组切皮前15min静脉注射帕瑞昔布钠40mg,B组切皮前15min静脉注射0.9%氯化钠溶液5ml,术毕2组患者均采用舒芬太尼患者自控静脉镇痛(PCIA)。分别与麻醉诱导前(T0)、术毕4h(T1)、术毕8h(T2)、术毕12h(T3)、术毕24h(T4)、术毕48h(T5)6个时间点用流式细胞仪检测T淋巴细胞亚群(CD3+、CD4+、CD8+、CD4+/CD8+)、及自然杀伤细胞(NK)。结果 2组T1～T4时CD3+、CD4+、CD8+、CD4+/CD8+、NK细胞值较T0均显著降低(P<0.05),至T5时基本恢复至T0水平,但A组在T1、T2、、T3、T4时CD3+、CD4+、CD8+、CD4+/CD8+及NK细胞下降幅度均显著低于B组(P<0.05)。结论帕瑞昔布钠切皮前给药对免疫系统有明显的保护作用。

Objective To investigate the effects of pre-incisional with parecoxib sodium on cellular immune function in patients undergoing radical resection of gastric carcinoma. Methods Forty patients undergoing selective radical resection of gastric carcinoma were randomly divided into two groups. Groups A （ analgesia group, n =20） were injected with 40rag parecoxib sodiumand groups B（ control group, n = 20） were injected with 5ml normal saline for 15 minutes before anesthesia induction. Then both groups received PCIA with fentanyl. T-lymphocyte subsets（ CD3＋ ,CD4＋ ,CD8 ＋ ,CD4＋/CD8 ＋ ） and natural killer（NK） cells were measured by flow cytometry at six time points. For example, before anesthesia induction （ T0）, at 4h after incision （ T1 ） , 8h （ T2）, 12h （T3） ,24h （T4）,48h（TS） after operation. Results Compared with T0,the values of CD3＋ ,CD4＋,CD8＋ , CD4＋/CD8＋ and NK ceils at T1, T2,T3 ,T4 decreased distinctly in both groups （ P 〈 0.05 ） ,T5 were normally the same with TO. But the decrease in group A were obvious less than those in group B （ P 〈 0.05 ）. Conclusion Pre-incisional with parecoxib sodium can improve the cellular immune function in patients undergoing radical resection of gastric Carcinoma.