丙泊酚与七氟烷麻醉对老年结肠癌根治术患者血液流变学及T淋巴细胞亚群的影响

Effect of propofol or sevoflurane on hemorheology and T lymphocyte subsets in elderly patients with colon cancer undergoing radical operation

目的探讨丙泊酚与七氟烷麻醉对老年结肠癌根治术患者血液流变学、T淋巴细胞亚群的影响。方法将60例于我院行结肠癌根治术治疗的老年结肠癌患者随机分为观察组和对照组,每组各30例。观察组行丙泊酚静脉麻醉,对照组行七氟烷吸入麻醉。观察2组患者麻醉前、诱导后30 min、诱导后90 min血液流变学变化情况以及麻醉前、术毕、术后72 h T淋巴细胞亚群变化。结果与麻醉前比较,2组诱导后30 min和诱导后90 min全血黏度(高、中、低切)、血浆黏度、红细胞聚集指数和红细胞变形指数均显著下降(P<0.05),各时间点2组间所有指标比较差异没有统计学意义(P>0.05);与麻醉前比较,2组术毕时CD45RA+和CD45RO+水平无明显变化(P>0.05),术后72 h,观察组CD45RA+和CD45RO+均无明显变化(P>0.05),对照组CD45RA+无明显变化(P>0.05),而CD45RO+活性显著降低,CD45RA+/CD45RO+比值显著升高,与麻醉前及观察组比较,差异均有统计学意义(P<0.05)。结论丙泊酚和七氟烷麻醉均能降低患者血液黏度,但丙泊酚对T淋巴细胞亚群无明显影响。

Objective To investigate the effect of propofol or sevoflurane on hemorheology and T lymphocyte subsets in the elderly patients with colon cancer undergoing radical operation. Methods A total of 60 patients with colon cancer undergoing radical operation were divided into observation group（ 30 cases） and control group（ 30 cases）. Control group received venous anesthesia with propofol,while observation group received inhalation anesthesia with sevoflurane. The hemorheology indexes were observed before anesthesia,30 min and 90 min after induction,and T lymphocyte subsets were observed before anesthesia,after operation and 72 h after operation. Results 30 min and 90 min after induction,blood viscosity（ high,middle and low shear）,plasma viscosity,erythrocyte aggregation index and erythrocyte of two groups were significantly decreased than before anesthesia（ P〈0. 05）,and all the indexes showed no significant differences between two groups（ P〉0. 05）; Compared with before anesthesia,there was no significant difference in the levels of CD45 RA ＋ and CD45RO＋ after operation in two groups（ P〉0. 05）. Compared with before anesthesia,there was no significant difference in the levels of CD45 RA ＋ and CD45 RO ＋ 72 h after operation in observation group（ P〉0. 05）. CD45 RA ＋ showed no significant changes in control group after operation（ P〉0. 05）,but CD45RO＋ was significantly decreased and CD45RA＋ /CD45RO＋ was significantly increased than that before anesthesia and in observation group（ P〈0. 05）. Conclusions Sevoflurane or propofol anesthesia can reduce blood viscosity,but propofol anesthesia shows little influence on T lymphocyte subsets.