术后镇痛对红细胞免疫功能的影响

Effect of postoperative epidural analgesia on erythrocyte immunity

目的 探讨术后镇痛对红细胞免疫功能的影响。方法 择期胆囊切除术患者 ,ASAⅠ～Ⅱ级 ,随机分为镇痛组 (以VAS≤ 3分者为试验对象 ,n =15 ) ,与对照组 ,分别在术前、术后 3d、术后7d采静脉血样检测红细胞C3b受体花环率 (RCR)、红细胞免疫复合花环率 (RICR)、自然肿瘤红细胞花环率 (NTERT)、红细胞免疫粘附促进因子 (RFER)及红细胞免疫粘附抑制因子 (RFIR)。结果 与对照组相比 ,镇痛组术前各指标无显著性差异 (P >0 0 5 ) ,术后 3d时RCR、RFER上升 ,RICR、RFIR下降 (P <0 0 1) ,术后 7d两组间差异无显著性 (P >0 0 5 )。与术前相比 ,镇痛组术后 3d各值无显著性差异 (P >0 0 5 ) ,术后 7d时RCR明显上升 (P <0 0 1) ;对照组术后 3dRCR、RFER及NTERT下降 ,RICR、RFIR上升 (P <0 0 5或 0 0 1) ,术后 7d时各值差异无显著性 (P >0 0 5 )。结论 术后镇痛有助于稳定红细胞的免疫功能。

Objective To investigate the effect of postoperative analgesia on erythrocyte immunity Methods The patients after cholecystotomy ,ASA grade Ⅰ Ⅱ , were randomly divided into two groups analgesia group with a VAS scores≤3 (n=15) ,and control group without analgesia (n=15) Venous blood samples were taken at pre operation, on postoperative 3rd and 7th day to measure the rosette rate of RBC C3b receptor (RCR), the complex rosette rate of red cell (RICR), the natural tumor erythrocyte rosette rate test (NTERT), the red cell immune adherence enhance factor rate (RFER) and the red cell adherence inhibitor factor rate (RFIR) Results There were not significant differences in the above parameters between both groups before operation and 7d after operation (P>0 05) , RCR and RFER were more higher , RICR and RFIR were greatly lower in analgesia group than those in control group 3d after operation(P<0 01) Compared with the baselines, all values remained stable 3d after operation(P>0 05), RCR increased markedly 7d after operation(P<0 01)in analgesia group; in control group RCR,RFER and NTERT decreased significantly , RICR and RFIR increased obviously 3d after operation(P<0 05 or 0 01), all values recovered(P>0 05) Conclusions Postoperative analgesia can help stabilize erythrocyte immunity function