不同麻醉方法对人外周血淋巴细胞促炎性细胞因子基因表达的影响

Expression of Genes for Proinflammatory Cytokines in Blood Lymphocyte Caused during Combined Anesthesia

目的 :研究复合麻醉中人外周血淋巴细胞IL - 8、IL - 1β基因表达 ,探讨异氟醚吸入和硬膜外阻滞对外周血炎性反应的影响。方法 :2 4例肝脏部分切除手术病人随机分为异氟醚组 (n =12 )和硬膜外组 (n =12 ) ,在麻醉诱导后即刻和 4h分别取静脉血 2 0ml用外周血淋巴细胞分离液 (Ficoll)进行梯度离心 ,从收获的淋巴细胞中提取RNA ,逆转录合成cDNA ,PCR后电泳扫描求积 ,检测淋巴细胞IL - 8、IL - 1β的mRNA表达。结果 :异氟醚组麻醉维持 4h后比麻醉诱导后即刻IL - 8、IL - 1β的表达增加 ,(P <0 .0 5 ) ,硬膜外组麻醉维持 4h与麻醉诱导后即刻IL - 8、IL - 1β的表达无明显变化 (P >0 .0 5 )。结论 :复合麻醉中吸入异氟醚能增强肝脏部分切除病人外周血淋巴细胞促炎性细胞因子mRNA表达 ,即在转录水平上 ,异氟醚能增强外周血炎性反应 ,而硬膜外阻滞无此效应。

Objective: To study the changes of interleukin-1β(IL-1β),IL-8 mRNA expression in blood lymphocytes during combined anesthesia. Methods: Patients undergoing hepatectomy were anesthetized with isoflurane (group I, n =12) or epidural combined anesthesia (group E, n =12). Lymphocytes were harvested by ladder centrifuge of blood immediately and 4h after induction of anesthesia. RNA was extracted from harvested cells and cDNA was synthesized by reverse transcription. Expression of IL-1β, IL-8 was measured by semiquantitative polymerase chain reaction using β- actin as an internal standard. Results: Gene expression of IL-8, IL-1β in lymphocytes increased significantly at 4h after induction of isoflurane anesthesia. There were no significant changes for the expression of the two cytokines during epidural combined anesthesia. Conclusion: Isoflurane anesthesia can provoke the systemic inflammatory response. there was no inflammatory response during epidural combined anesthesia.