帕瑞昔布钠对乳腺癌根治术患者细胞免疫及IL-6的影响

Effects of Parecoxib Sodium on Cellular Immune Function and IL-6 Levels in Patients Undergoing Radical Mastectomy for Breast Cancer

目的评价帕瑞昔布钠对乳腺癌根治术患者细胞免疫及IL-6的影响。方法选取择期在全身麻醉下行乳腺癌改良根治术的女性患者40例,年龄35~55岁,ASA分级Ⅰ或Ⅱ级。采用随机数字表法将其分为对照组(C组,n=20)和帕瑞昔布钠组(P组,n=20)。术毕2组患者均采用舒芬太尼患者自控静脉镇痛(PCIA)。P组于术毕即刻,术后12、24和36h时静脉注射帕瑞昔布钠40mg;C组给予等容量生理盐水。分别于麻醉诱导前(T0)、术后2、6、12、24、48及72h(T1-T6)时采集外周静脉血样,用流式细胞仪测定T淋巴细胞亚群(CD3+、CD4+、CD8+、CD4+/CD8+)水平和自然杀伤(NK)细胞(CD3+/CD16+CD56+)活性数百分比;采用酶联免疫吸附法测定血浆IL-6含量。结果与C组比较,P组T1-T4时CD+3、CD+4及NK细胞百分比升高,T1-T5时CD+4/CD+8升高,T1-T6时IL-6水平降低(P<0.05),CD+8水平各时点差异无统计学意义(P>0.05);与T0比较,T1-T3时2组患者CD+3、CD+4、CD+4/CD+8及NK细胞百分比降低,T1-T5时IL-6水平升高(P<0.05)。结论帕瑞昔布钠可减轻乳腺癌根治术患者围术期免疫功能的抑制及减少IL-6的分泌,对乳腺癌患者免疫系统具有一定保护作用。

Objective To investigate the effects of parecoxib sodium on cellular immune func- tion and IL-6 levels in patients undergoing radical mastectomy for breast cancer. Methods Forty female ASA I or II patients （age 35-55 years） scheduled for modified radical mastectomy under general anesthesia were randomly divided into two groups, with 20 patients in each group. All pa- tients were given sufentanil for patient-controlled intravenous analgesia. Furthermore, parecoxib group（group P） was intravenously administered parecoxib sodium 40 mg at the end of operation and 12,24 and 36 hours after operation. Control group（group C） was given the same volume of normal saline at the same time points. Peripheral venous blood was drawn before the induction of anesthesia（T0 ） and at 2（T1 ）, 6（T2 ）, 12（T3 ） ,24（T4 ） ,48（Ts ） and 72（T6 ） after operation. T-lym- phocyte subsets （CD3＋, CD4＋, CD＋ and CD4＋/CD/） and natural killer cells （CD3＋/CD16＋ and CD56＋ ） were measured by flow cytometry. Plasma IL-6 levels were measured by ELISA. Results Compared with group C,parecoxib sodium induced an increase in the percentages of CD＋ ,CD＋ , CD16＋ and CD56＋ cells at T1-T4 ,an elevation in the percentages of CD4＋/CD＋ cells at T1-T5 ,and a decrease in plasma IL-6 levels at T1-T6 （P（0.05）. There were no significant differences in the percentages of CI）＋ cells between the two groups（P^0.05）. Compared with To, the percentages of CD3 ,CD＋ ,CD＋/CD＋ ,CD＋/CD16＋ and CD56＋ cells decreased at T1-T3 and IL-6 levels increased at T1-T5 in both groups（P（0. 05）. Conclusion Pareeoxib sodium exerts a protective effect on immune system through alleviating immunosuppression and reducing IL-6 secretion in patients undergoing radical masteetomy for breast cancer.