摘要
目的 探讨右美托咪定对感染性休克患者术后免疫功能及炎症因子的影响.方法 选取2012年10月至2013年10月在本院行手术治疗的84例感染性休克患者,根据随机数字表将患者分为丙泊酚组及右美托咪定组各42例,采用Beckm Epics流式细胞仪测定麻醉诱导前、术毕、术后1、3、7d时免疫细胞（CD3＋、CD4＋、CD4 ＋/CD8＋）的数量、采用免疫比浊法测定C-反应蛋白（CRP）数量,采用酶联免疫吸附试验（ELISA法）测定白细胞介素（IL）-6,IL-8水平.结果 右美托咪定组术后认知障碍（POCD）发生率低于丙泊酚组,差异有统计学意义（4.76％比23.89％,P=0.013）;与麻醉前相比,右美托咪定组术后感染率低于丙泊酚组,差异有统计学意义（2.38％比21.43％,P=0.0007）;两组患者手术结束时CD3＋、CD4＋、CD4＋/CD8＋水平下降,且丙泊酚组下降显著;与麻醉前相比,两组患者手术结束时CRP、IL-6,IL-8水平显著升高,且丙泊酚组升高显著.结论 右美托咪定对感染性休克患者术后免疫功能影响较小,能减轻炎症反应对机体的影响,从而降低POCD及围手术期感染发生率.
Objective To study the effect of dexmedetomidine on the immune system function and inflammatory factors in postoperative patients with septic Shock.Methods From October 2012 to October 2013,84 patients in our hospital undergoing surgery for septic Shock were divided into two groups according randomnumber table（n =42 each）：dexmedetomidine group and control group（propofol）.The levels of immune cells （CD3 ＋,CD4 ＋,CD4 ＋/CD8 ＋） of two groups were determined with Beckm Epics flow cytometry at time of preoperation,postoperation,and 1,3,7days after operation,the levels of C-reactive proteinl （CRP） were determined with Immunoturbidimetry,and the levels interleukin （IL）-6,IL-8 were determined with enzyme-linked immanosorbent assay（ELISA）.Results The rate of postoperative cognitive dysfunction（POCD） in dexmedetomidine group is lower than control group （propofol） （4.76% vs 23.89%,P =0.013）;the rate of postoperative infection is lower than control group（propofol） （2.38 vs21.43,P =0.0007）;the levels of CD3＋,CD4＋,CD4＋ /CD8 ＋ in two groups are both higher than the dexmedetomidine group;the levels of CRP and IL-6,IL-8 in two groups are both lower than the dexmedetomidine group.Conclusion Dexmedetomidine has less effect on immune system functon in patients with setic Shock,and can reduce the rate of post operatove congnitive dysfuncition（POCD） and the rate of perioperative infection incidence by reducing the effects of inflammation on the body.
出处
《国际免疫学杂志》
CAS
2016年第1期34-37,共4页
International Journal of Immunology
