帕瑞昔布钠对乳腺癌根治术患者围术期免疫功能的影响

Effects of parecoxib sodium on the immune function of patients undergoing breast cancer radical mastectomy during the perioperative period

目的观察帕瑞昔布钠对乳腺癌根治术患者围术期免疫功能的影响。方法将40例乳腺癌根治术患者随机分为两组,P组为术前15 min静脉注射帕瑞昔布钠40 mg,T组为术前15 min静脉注射曲马多100mg。观察两组患者于术后2、4、8、12和24 h的视觉模拟评分(VAS评分)以及术后2 h各种副作用,并分别于术前30 min(T0)、术毕即刻(T1)、术后12h(T2)、术后24 h(T3)4个时间点,流式细胞仪测定T淋巴细胞亚群(CD4+、CD8+)的水平及CD4+/CD8+比值以及采用酶联免疫吸附法(ELISA)测定其血浆IL-6和IL-10含量。结果两组患者各时点VAS评分没有显著性(P>0.05);T组的恶心呕吐率明显高于P组(P<0.05);两组在T0时点T淋巴细胞亚群(CD4+、CD8+)的水平及CD4+/CD8+比值及IL-6、IL-10含量差异无显著性(P>0.05);两组患者在T1和T2时点P组CD4+水平明显高于T组患者(P<0.05),而CD8+含量明显低于T组患者(P<0.05);两组T1、T2和T3的CD4+/CD8+比值较T0均下降,但P组在T1和T2时CD4+/CD8+比值明显高于T组(P<0.05)。在T2和T3时点,IL-6T组明显高于P组,IL-10T组明显低于P组,差异有显著性(P<0.05)。结论帕瑞昔布钠对于乳腺癌根治术患者围术期的免疫功能影响较小。

【Objective】To study the effects of parecoxib sodium on immune function in patients of breast cancer radical mastectomy during the perioperative period.【Methods】Forty patients undergoing selective radical resection of breast were randomly divided into two groups.Group P were injected with 40 mg parecoxib sodium in perioperative 15 minites＇time and group T were injected with 100 mg Tramadol.Both groups were evaluated by visual analogue scale（VAS） at 2 h,4 h,8 h,12 h,24 h and side effects at 2h and tlymphocyte subpopulations（CD4^＋ and CD8^＋ cell） were determined by fluorescence activating cell sorter and the contents of plasma IL-6,IL-10 were determined by enzyme linked immunosorbent assay.【Results】No significant differences were found between the two groups according to VAS（P〈0.05）,but the rate of nausea and vomitting was higher in group T than group P（P〈0.05）.At T1,T 2,the level of CD4 ＋ was lower in group T than group P,but the level of CD8 ＋ was higher in group T than group P.At T 2,T 3,the content of plasma IL-6 was found significantly higher but the content of plasma IL-10 was much lower in group T than that in group P.【Conclusion】Parecoxib sodium has little effect on immune function in patients of breast cancer radical mastectomy during the perioperative period.