镇静药物对于TURP患者外周血细胞因子表达水平的影响

Effect of sedation drugs on the expression of cytokines in peripheral blood of patients after TURP

目的探讨术中应用不同镇静药物对患者外周血Th1/Th2细胞因子表达水平的影响。方法选取择期行经尿道前列腺切除术(TURP)的男性患者66例,随机分为3组。对照组:术中输注生理盐水;咪达唑仑组:术中输注咪达唑仑镇静;右美托咪定组:术中输注右美托咪定镇静。术中应用BIS监测镇静深度,BIS<80认为患者处于镇静状态。采集麻醉后和术后24 h动脉血,应用酶联免疫试验试剂盒检测血浆IFN-γ、IL-4水平,以IFN-γ和IL-4水平计算Th1/Th2。结果术后24 h,对照组IL-4表达增加,咪达唑仑组IFN-γ表达增加(P<0.05),三组Th1/Th2比率与基础值比较差异有统计学意义,咪达唑仑组Th1/Th2比率升高(P<0.05)。结论椎管内麻醉下行TURP手术的男性患者术中给予咪达唑仑镇静,可提高术后24 h的外周血Th1/Th2比率。

Objective To investigate the effect of sedation drugs on Thl/Th2 expression m peripheral mooo of patients after transurethral resection of prostate （TURP）. Methods Totally 66 patients undergoing TURP were ran- domly assigned into three groups. Patients in control group, dexmedetomidine group and midazolam group were given infusion saline, dexmedetomidine or midazolam iv. for sedation during the surgery. Sedative state was identified when BIS was less than 80. Plasma samples were taken at 10 rain after spinal anesthesia （baseline） and 24 h after operation,and the IFN-y and IL-4 levels were measured by commercially available radioirnmunoassay kits to calculate the Thl/ Th2 ratio. Results The expression of IL-4 in control group and IFN-~/ in midazolam group both increased （ P 〈 0. 05 ）. There was significant difference in Th1/Th2 ratio among the three groups, and the Thl/Th2 ratio in midazolam group increased （ P 〈 0. 05 ）. Conclusion Administration of midazolam can increase the Thl/Th2 ratio of male pa- tients after transurethral prostatic resection under intrathecal anesthesia.