氟比洛芬酯超前镇痛对脑胶质瘤切除术患者T淋巴细胞亚群的影响

Effect of Preemptive Analgesia of Flurbiprofen Axetil on Immune Function in Patients Accepting Resection of Neuroglioma

目的:探讨氟比洛芬酯超前镇痛对脑胶质瘤切除术患者T淋巴细胞亚群的影响。方法:48例择期行脑胶质瘤切除术患者,均分为研究组和对照组,研究组切皮前静脉注射氟比洛芬酯50 mg,对照组给予等量生理盐水,采用流式细胞仪分别检测2组患者麻醉前(T_0)、术毕(T_1)、术后第1天(T_2)和术后第3天(T_3)时外周静脉血T淋巴细胞亚群(CD3^+,CD4^+,CD8^+)、活化T细胞(CD3^+HLA-DR^+)和自然杀伤细胞(NK细胞)百分比,并比较2组患者术毕视时的觉模拟(VAS)评分。结果:与T_0时点相比,2组患者CD3^+、CD4^+、CD4^+/CD8^+、CD3^+HLA-DR^+和NK细胞百分比在T_1、T_2时点均降低,T_2时点降低更明显(P<0.05);研究组T_3时点的上述指标与T_0时点相比,差异无统计学意义(P>0.05);而对照组T_3时点的上述指标仍低于T_0时点(P<0.05),研究组T_1～T_3时点以上指标均高于对照组(P<0.05);2组患者T_0～T_3各时点CD8^+百分比比较,差异无统计学意义(P>0.05);研究组术毕VAS评分低于对照组(P<0.05)。结论:氟比洛芬酯超前镇痛能减轻脑胶质瘤切除术患者细胞免疫功能的抑制,并能明显减轻术后急性疼痛。

Objective： To investigate the effect of preemptive analgesia of flurbiprofen axetil on immune function in patients who accepted resection of neuroglioma. Methods： Forty-eight patients who accepted scheduled resection of neuroglioma were randomly and equally divided into the study group and the control group. The study group received intravenous injection of flurbiprofen（ 50 mg） respectively before skin incision,while the control group received normal saline（ 5 m L）. 2 m L of peripheral venous blood was obtained before anesthesia（ T0）,in the end of operation（ T1）,1 d after operation（ T2） and 3 d after operation（ T3）. Flow cytometry was used to detect T lymphocyte subsets（ CD3^＋,CD4^＋,CD8^＋）,activated T cells（ CD3^＋HLA-DR^＋） and natural killer cells（ NK cells）. The visual analogue scale（ VAS） scores of both groups were recorded after operation. Results： Compared with T0,the percentages of CD3^＋,CD4^＋,CD4^＋/CD8^＋,CD3^＋HLA-DR^＋and NK cells in both groups decreased at T1 and T2（ P〈0. 05）,with the lowest level at T2. The above indices in the study group returned to the level of T0 at T3（ P〉0. 05）,while they were still lower than those at T0 in the control group（ P〈0. 05）. All the indices in the study group were higher than those in the control group from T1 to T3（ P〈0. 05）. The VAS scores were lower in the study group than those in the control group after operation（ P〈0. 05）. Conclusion： Preemptive analgesia of flurbiprofen axetil can reduce the cellular immune suppression in patients with resection of neuroglioma,and can significantly alleviate acute postoperative pains.