帕瑞昔布钠对妊娠糖尿病患者围术期炎症因子的影响

Effect of parecoxib on perioperative inflammatory factors in patients with gestational diabetes mellitus

目的探讨帕瑞昔布钠对妊娠糖尿病患者围术期炎症因子的影响。方法连续收集2016年1~3月云南省第一人民医院妊娠糖尿病患者30例,所有患者均拟在硬膜外麻醉下行剖宫产术,按随机数表法随机分为帕瑞昔布钠组(P组)15例和对照组(C组)15例。P组患者在胎儿娩出后静脉注射帕瑞昔布钠40mg,C组患者静脉注射相同体积的生理盐水,分别于麻醉前(T1)、胎儿娩出后即刻(T2)、术毕(T3)、术后6 h(T4)、术后12 h(T5)抽取静脉血样,测定血浆肿瘤坏死因子-α(TNF-α)、白细胞介素-6(IL-6)、白细胞介素-10(IL-10)浓度。结果两组患者的TNF-α、IL-6、IL-10水平均较术前升高,差异均有统计学意义(P<0.05或P<0.01);在T3、T4、T5时,P组患者的TNF-α、IL-6水平低于C组,IL-10水平高于C组,差异均有统计学意义(P<0.05或P<0.01)。结论妊娠糖尿病患者围术期使用帕瑞昔布钠能有效抑制炎症反应。

Objective To investigate the effect of parecoxib on perioperative inflammatory factors in patients with gestational diabetes mellitus. Methods A total of thirty patients with gestational diabetes mellitus, who admitted to the First People＇s Hospital of Yunnan Province and received epidural anesthesia undergoing cesarean section, were divided randomly and equally into the parecoxib group（group P, n=15） and the control group（group C, n=15）. The group P received 40 mg parecoxib after fetal disengagement, and the group C received intravenous normal saline. Venous blood samples were taken before anesthesia（T1）, after fetal disengagement（T2）, at the end of operation（T3）, at 6 h and 12 h after operation（T4, T5） for the determination of serum tumour necrosis factor-α（TNF-α）, interleukin-6（IL-6） and interleukin-10（IL-10）. Results The levels of TNF-α, IL-6 and IL-10 of all patients were significantly higher than those before operation（P0.05 or P0.01）. At stage T3, T4 and T5, the levels of serum TNF-α and IL-6 in the group P were significantly lower than those in the group C, while the level of serum IL-10 in the group P was significantly higher than that in the group C（P0.05 or P0.01）. Conclusion Parecoxib can effectively inhibit the perioperative inflammatory response in patients with gestational diabetes mellitus.