不同剂量氟比洛芬酯注射液对分化型甲状腺癌术后镇痛效果和炎症因子水平的影响

The effect of different doses of flurbiprofen axetil injection on the analgesia and inflammatory cytokine levels in patients with differentiated thyroid cancer

目的:探讨不同剂量氟比洛芬酯注射液对分化型甲状腺癌术后镇痛效果和炎症因子水平的影响。方法:选取120例分化型甲状腺癌病人作为研究对象,随机分为4组,麻醉诱导结束后分别给予0.9%氯化钠注射液(对照组)及氟比洛芬酯0.5mg/kg(D1组)、1.0 mg/kg(D2组)、1.5 mg/kg(D3组),每组30例。采用视觉模拟评分法(VAS)评估病人术后疼痛程度。酶联免疫吸附法测定血清白细胞介素IL-6、IL-8和肿瘤坏死因子-α(TNF-α)的水平。结果:D1组、D2组和D3组术后24 h VAS评分均显著低于术后2 h(P<0.01)。术后2、12、24 h,D1组、D2组和D3组的VAS评分均显著低于对照组(P<0.01)。D1组、D2组和D3组血清IL-6、IL-8和TNF-α水平均显著低于对照组(P<0.01)。D3组IL-6、IL-8和TNF-α水平均显著低于其他各组(P<0.01)。4组不良反应发生率差异无统计学意义(P>0.05)。结论:通过影响炎症细胞因子水平,氟比洛芬酯1.5 mg/kg能更显著降低术后炎症反应状态,有利于病人术后的恢复。

Objective： To study the effect of different doses of flurbiprofen injection on the analgesia and inflammatory cytokine levels in patients with differentiated thyroid cancer. Methods： One hundred and twenty patients with thyroid cancer in our hospital were selected as the research object. The patients were randomly divided into flurbiprofen axetil 0. 5 mg/kg group in each group（ group D1）,flurbiprofen axetil 1 mg/kg group（ group D2）,flurbiprofen axetil 1. 5 mg/kg group（ group D3） and the control group of 30 cases in each group. The patients were given different dose of flurbiprofen in the end of the induction of anesthesia. The visual analogue scale（ VAS）was used to assess the degree of pain in patients. The level of interleukin-6（ IL-6）,interleukin-8（ IL-8） and tumor necrosis factor-α（ TNF-α） were measured by enzyme-linked immunosorbent assay（ ELISA）. The adverse reactions were observed in each group.Results： The VAS score of postoperative 24 h was significantly lower than that of postoperative 2 h in group D1,group D2 and group D3. VAS score of postoperative 2 h in group D2 and group D3 was significantly lower than those in control group. VAS score of postoperative 12 h in group D1,group D2 and group D3 was significantly lower than that in control group. VAS score of postoperative 24 h in group D2 and group D3 was significantly lower than that in control group. The serum IL-6,IL-8 and TNF-α levels of group D1,group D2 and group D3 were significantly lower than those of the control group,the difference was statistically significant（ P〈0. 05）.The levels of IL-6,IL-8 and TNF-α in group D3 were significantly lower than those in other groups. There were no statistical difference in the incidence of adverse events in the four groups. Conclusions： Flurbiprofen axetil 1. 5 mg/kg can significantly decrease the level of serum IL-6,IL-8 and TNF-α,and there were no significant increase in adverse reactions.