丙泊酚和异氟醚对老年脑膜瘤患者抗炎疗效分析

Anti-inflammation effect of propofol and isoflurane in elderly meningioma patients

目的初步分析丙泊酚和异氟醚对老年脑膜瘤患者的抗炎疗效,观察抗炎性细胞因子白细胞介素13(IL-13)、白细胞介素10(IL-10)及白细胞介素4(IL-4)的改变。方法选择脑膜瘤手术老年患者65例,根据性别随机分为丙泊酚组(33例)和异氟醚组(32例),分别在麻醉诱导前、术后0、24、48 h各抽取静脉血5 m L,检测血清抗炎性因子中IL-13、IL-10和IL-4含量。结果丙泊酚组脑膜瘤老年患者与异氟醚组比较,麻醉诱导前和术后0 h血清IL-13、IL-10和IL-4含量差异均无统计学意义(均P>0.05);术后48 h,丙泊酚组IL-13、IL-10和IL-4含量[分别为(80.69±15.61)、(137.49±25.9)、(65.78±12.40)ng/L]均明显高于异氟醚组[分别为(62.56±12.41)、(112.02±21.82)、(52.45±9.24)ng/L](P<0.05)。结论老年脑膜瘤患者使用丙泊酚比异氟醚吸入能更好地降低术后炎性作用。

Objective To analyze the influence of propofol and isoflurane on anti-inflammation in elderly patients with meningioma. Methods Sixty-five patients of Ⅰ or Ⅱ of American Society of Anaesthesiology（ASA）category and undergoing meningioma surgery were divided randomly into a propofol group （33 patients ）and an isoflurane group（ 32 patients ）. The patients of propofol group were given intravenous anesthesia with target controlled infusion of propofol 3 - 6 μg/mL, and those of the isoflurane group received continuous inhalation anesthesia with isoflurane of 1% -2%. Ve- nous blood samples （ 5 ml for each） of the patients were collected before anesthesia induction and 0,24, and 48 hours after the operation for detections of interleukin 13 （ IL-13 ）, interleukin 10 （ IL-10 ）, and interleukin 4 （ IL4 ）. Results There were no significant differences in IL-13, IL-10, and IL-4 before anesthesia induction and 0 hour after the operation be- tween propofol and isoflurane group. The serum levels of IL-13, IL-10, and IL-4 were significantly lower in isoflurane group than those in propofol group at 48 hours after the operation （ all P 〈 0. 05 ）. Conclusion The effect of propofol is better than that of isoflurane in inhibiting inflammatory reaction in elderly patients with meningioma.