舒芬联合丙泊酚和司可林对纤维支气管镜检查中应激反应及免疫应答的影响

Effect of sufentanil combined with propofol and scoline on stress response and immune response in fiberoptic bronchoscopy

目的:探讨舒芬联合丙泊酚和司可林对纤维支气管镜检查中应激反应及免疫应答的影响。方法:收集2015年3月~2017年4月在本院进行纤维支气管镜检查的患者138例,经随机数表法分为常规组及司可林各69例。常规组接受舒芬太尼联合丙泊酚麻醉,司可林组接受舒芬太尼、丙泊酚联合司可林麻醉。对比两组检查前后血清应激激素、肺内灌洗液免疫指标含量的差异。结果:检查前,两组血清中应激激素,肺内灌洗液中Th1/Th2细胞因子、Th17/Treg细胞因子含量的差异无统计学意义;检查结束即刻,司可林组血清中应激激素Cor、E、NE的含量低于常规组;肺内灌洗液中Th1细胞因子IL-2、IFN-γ的含量高于常规组,Th2细胞因子IL-10、IL-13的含量低于常规组;肺内灌洗液中Th17细胞因子IL-17的含量低于常规组,Treg细胞因子IL-23的含量高于常规组。结论:小剂量司可林加入纤维支气管镜检查麻醉中,可有效减轻患者的全身应激状态,同时避免免疫应答功能急性损伤。

Objective:To explore the effect of sufentanil combined with propofol and scoline on stress response and immune response in fiberoptic bronchoscopy.Methods:A total of 138 patients with fiberoptic bronchoscopy in the hospital between March 2015 and April 2017 were collected and divided into routine group and scoline group by random number table,69 cases in each group.Routine group received sufentanil combined with propofol anesthesia,and scoline group received sufentanil,propofol combined with scoline anesthesia.The differences in the levels of stress hormones in serum and immune indexes in alveolar lavage fluid were compared between the two groups before and after examination.Results:Before examination,the differences in the levels of Th1/Th2 cytokines in serum as well as Th1/Th2 cytokines and Th17/Treg cytokines in alveolar lavage fluid were not statistically significant between the two groups;immediately after examination,serum stress hormones Cor,E and NE levels of scoline group were lower than those of routine group;Th1 cytokines IL-2 and IFN-γlevels in alveolar lavage fluid were higher than those of routine group while Th2 cytokines IL-10 and IL-13 levels were lower than those of routine group;Th17 cytokine IL-17 level in alveolar lavage fluid was lower than that of routine group while Treg cytokine IL-23 level was higher than that of routine group.Conclusions:Small-dose scoline for fiberoptic bronchoscopy anesthesia can effectively relieve the systemic stress state and avoid the acute injury of immune response function.