地佐辛对乳腺癌患者术后应激反应及免疫功能的影响

Effects of dezocine on postoperative stress response and immune function in patients with breast cancer

目的::探讨地佐辛对乳腺癌患者术后应激反应及免疫功能的影响。方法:选取2016年9月~2017年5月我院收治的拟行乳腺癌根治术的患者80例,依据随机数据表法分为观察组和对照组,每组40例。麻醉诱导前15min观察组给予地佐辛静脉注射作为超前镇痛,对照组给予等量氯化钠注射液。分别检测并比较两组患者术前及术后应激反应、免疫功能指标变化。结果:术前,两组的血管紧张素Ⅱ、肾素、皮质醇、醛固酮、CD3^+、CD4^+、CD8^+、CD4^+/CD8^+水平比较,差异无统计学意义(P>0.05)。两组患者术后血管紧张素Ⅱ、肾素、皮质醇、醛固酮水平先升高后降低,术后1d、术后3d时均明显高于术前,且观察组术后1d、术后3d时血管紧张素Ⅱ、肾素、皮质醇、醛固酮水平显著低于对照组同时间点,差异对比有显著性(P<0.05)。两组患者术后血清CD3^+、CD4^+及CD4^+/CD8^+水平先降低后升高,术后1d、术后3d时均显著低于术前,且观察组术后1d、术后3d时CD3^+、CD4^+及CD4^+/CD8^+显著高于对照组同时间点,上述指标比较,差异显著有统计学意义(P<0.05);两组患者术后血清CD8^+水平先升高后降低,术后1d、术后3d时均显著高于术前,且观察组术后1d、术后3d时CD8^+显著低于对照组同时间点,上述指标比较,差异显著有统计学意义(P<0.05)。此外术后5d时,两组患者体内上述指标已恢复至术前水平。结论:地佐辛能够降低围术期乳腺癌患者应激反应,改善患者免疫功能,具有重要临床价值,值得大力推广。

Objective:To investigate the effects of dezocine on postoperative stress response and immune function in patients with breast cancer.Methods:According to random data table method,a total of 80 patients who were scheduled for breast cancer radical surgery from September 2016 to May 2017 were divided into observation group and the control group,40 cases in each group.The observation group given intravenous injection of dezocine as an advanced analgesia 15 min before anesthesia induction,the control group given the same amount of sodium chloride injection.The levels of serum inflammatory factors and immune function were measured and compared between the two groups before and after operation.Results:The levels of angiotensin Ⅱ,renin,cortisol,aldosterone,CD3^+,CD4^+,CD8^+and CD4^+/CD8^+in the two groups before treatment were not statistically significant(P>0.05).The levels of angiotensin Ⅱ,renin,cortisol,aldosterone in the two groups were increased at first and then decreased,which were significantly higher than those in the same group before operation at 1 day and3 days(P<0.05);and the levels of angiotensinⅡ,renin,cortisol,aldosterone in the observation group were significantly lower than those in the control group after 1 day and 3 days,the difference was statistically significant(P<0.05).The levels of serum CD3^+,CD4^+and CD4^+/CD8^+in the two groups were decreased at first and then increased,which were significantly lower than those in the same group before operation at 1 day and 3 days(P<0.05);and the observation group levels were significantly higher than those in the control group after 1 day and 3 days,the above indicators were compared with the difference was statistically significant(P<0.05).The levels of serum CD8^+in the two groups were increased at first and decreased subquently,which were significantly higher than those in the same group before operation at 1 day and 3 days(P<0.05)and the observation group levels were significantly lower than those in the control group after 1 day and 3 days,the above indicators were compared with the difference was statistically significant(P<0.05).The above indicators have restore to preoperative levels after 5 days.Conclusion:Dezocine can reduce the stress response in patients with perioperative breast cancer,improve the immune function of patients,which has important clinical value,so it is worth promoting.