丙泊酚静脉麻醉对原发性肝癌围手术期T辅助细胞的影响

Influence of propofol intravenous anesthesia on T helper cells of patients with primary liver cancer in perioperative period

目的探讨丙泊酚静脉麻醉对原发性肝癌围手术期T辅助细胞的影响。方法选取2014年11月至2015年10月我院收治的86例原发性肝癌患者,根据随机数字法分为观察组和对照组,每组43例,观察组采取丙泊酚静脉麻醉,对照组采用七氟醚吸入麻醉。比较2组患者麻醉前和术后1 d Th1细胞百分比、Th2细胞百分比、Th1细胞/Th2细胞之比变化情况,观察2组患者在麻醉前、麻醉后、术中、术后1 d血浆皮质醇水平。结果 2组患者术后1 d的Th2细胞百分比比较,差异无统计学意义(P>0.05),观察组的Th1细胞百分比、Th1细胞/Th2细胞比值均高于对照组[(16.32±1.76)%vs.(14.16±1.03)%,(8.48±0.92)vs.(7.11±0.72)],差异均具有统计学意义(P<0.05)。观察组在术中、术后1 d的血浆皮质醇水平低于对照组[(12.34±1.02)μg/d L vs.(16.13±1.26)μg/d L,(12.01±0.94)μg/d L vs.(15.25±1.08)μg/d L],差异有统计学意义(P<0.05)。结论丙泊酚静脉麻醉更能促使Th细胞朝着Th1方向分化,对患者的免疫功能发挥着保护性作用。

Objective To study the effect of propofol intravenous anesthesia on T helper cells of patients with primary liver cancer dur- ing perioperative period. Methods A total of 86 patients with primary liver cancer in our hospital from November 2014 to October 2015 were selected, who were divided into observation group and control group according to the method of random numbers ,43 cases in each group. The observation group were taken propofol intravenous anesthesia, and the control group were treated with sevoflurane inhalation anesthesia. The Thl cells percentage,Th2 cells percentage and the ratio changes of the Thl/Th2 cells of two groups before anesthesia and postoperative 1 day were compared. The plasma cortisol levels of two groups before anesthesia, after anesthesia,intraoperative and 1 day after operation were observed. Results The percentage of Th2 cells in observation group and control group 1 day after surgery had no significant difference （ P 〉 0.05 ）. The percentage of Thl cells and Thl/Th2 cells ratio of the observation group were higher than those of the control group [ （ 16.32 ± 1.76） % vs. （ 14.16 ± 1.03 ）, （ 8.48 ± 0.92 ） vs. （ 7.11± 0.72 ） ], the differences were significant （ P 〈 0.05 ）. The plasma cortisol levels of observation group during operation and 1 day after operation were lower than those of the control group[ （ 12.34 ± 1.02） μg/dL vs. （ 16.13 ± 1.26） μg/dL, （ 12.01 ± 0.94 ） μg/dL vs. （ 15.25 ± 1.08 ） μg/dL ] , the differences were significant （ P 〈 0.05 ）. Conclusion The propofol intravenous an- esthesia can encourage more Th to differentiate into Thl cells,which plays a protective role in the patient＇s immune function.