异丙酚-异氟醚复合麻醉对CD_(25)表达及T细胞亚群影响的临床研究

The Influence of Propofol-Isoflurane Combined Anaesthesia on the T Cell Subpopulations and CD_(25) Expression

为研究异丙酚 -异氟醚静吸复合麻醉与硬膜外阻滞麻醉对择期经腹胆囊切除术患者 T淋巴细胞及其亚群及白介素 2受体 (CD2 5)表达的影响 ,将 40例患者随机分为二组。硬膜外麻醉组和异丙酚 -异氟醚静吸复合全麻组各 2 0例。于麻醉前即患者入室后 10 min,麻醉后 6 0 m in分别采取外周静脉血 4m l经密度梯度法分离淋巴细胞 ,采用单克隆抗体花环法、免疫组织化学法分别检测 T细胞亚群及淋巴细胞 CD2 5。结果 :麻醉后 6 0 min,全麻组 CD+ 3 、 CD+ 4 、 CD+ 8细胞均呈增加趋势 ,且 CD+ 3 、CD+ 4 细胞增高具有显著差异 (P<0 .0 5 ) ,而硬膜外组仅 CD+ 4 呈增高趋势 (P>0 .0 5 )。CD+ 3 细胞变化两组间具有显著差异 (P<0 .0 5 )。CD+ 2 5细胞变化两组间无显著差异 (P>0 .0 5 )。但全麻组麻醉后 CD2 5细胞明显增加 (P<0 .0 5 )。认为两种麻醉方法对 T细胞亚群及淋巴细胞 CD2 5的影响不同。与硬膜外麻醉相比 ,异丙酚 -异氟醚静吸复合全麻使

The changes of T cell subpopulations (CD + 4, CD + 8 cell) and CD 25 +cells and CD 25 expression in 40 patients undergoing elective cholecystectomy using either epidural or propofol and isoflurane combined anaesthesia (general anaesthesia) were investigated. Mononuclear cells and erythrocytes were simultaneously isolated before anaesthesia and during operation (60 min after anesthesia induction). Monoclonal antibodies to CD + 3, CD + 4, CD + 8 T cells of the T cell subpopulations were identified. CD 25 was assessed by immunohistochemistry method. In the patients receiving general anaesthesia, the percentages CD + 3, CD + 4 CD + 8 of the cells were all increased, which were accompanied with a rise of CD 25 + cell numbers ( P <0.05). There was a significant difference in CD + 3 cells between the two groups. It suggests that under the general anaesthesia, T cell immunity tends to be activation. Epidural anaesthesia may be more beneficial to the patients undergoing upper abdominal surgery from the point of view of the immune.