术后镇痛对红细胞免疫黏附功能及其调节因子的影响

Effects of Post-operative Epidural Analgesia on Erythrocyte Immunity and It's Modulatory Factors

目的 :研究术后镇痛对红细胞免疫黏附功能及其调节因子的影响。方法 :选择择期在硬膜外联合全身麻醉行胸外科手术病例 32例 ,随机分为术后镇痛组 (A)和对照组 (C) ,分别在术前、术后 1d、3d、7d采静脉血 ,检测红细胞酵母菌花环率(RYRR)、红细胞免疫复合物花环率 (RICRR)、肿瘤细胞红细胞花环率 (TRRR)、红细胞免疫黏附促进因子 (RFEF)、红细胞免疫黏附抑制因子 (RFIF)和血浆 β-内啡肽 (β -EP)含量。结果 :术前各检测值两组间无显著差异 (P >0 .0 5 ) ;A组术后 1d及C组术后 1d、3dRYRR、TRRR、RFEF明显下降 (P <0 .0 5 ,P <0 .0 1) ,RICRR、RFIF、β -EP浓度明显增加 (P <0 .0 5 ,P <0 .0 1) ;术后 3d两组间RYRR、RICRR、TRRR、RFEF和β -EP浓度差异显著 (P <0 .0 5 ,P <0 .0 1) ;术后 7d两组各指标恢复至术前水平 ;两组血浆 β-EP与RYRR呈负相关 (r=- 0 .92 4 ,P <0 .0 1)。结论 :术后镇痛能显著改善手术。

Objective: To study the effects of post-operative epidural analgesia on erythrocyte immunity and it's modulatory factors. Methods: Thirty-two elective thoracic operation patients under epidural combined with general anesthesia were enrolled and allocated randomly into analgesia group(A) and control group(C),venous blood samples were taken pre-opration,1d,3d,7d after operation, red blood cells-yeast cells rosette rate(RYRR),the red blood cells-tumur cells rosette rate(TRRR),the red blood cells-immune complex rosette rate(RICR),the rosette forming enhancing factor(RFEF), the rosette forming inhibitory factor(RFIF) and the level of serum beta-endorphin(β-EP) were measured. Results: There was no significant difference between two groups pre-operation with regard to the monitored values.RYRR,TRRR and RFEF decreased,while RICRR,RFIF and β-EP increased dramatically 1d after operation in A and 1d,3d after operation in C( P<0.05, P <0.01),respectively.Serum content of β-EP appeared negative correlation to RYRR( r=-0.924,P <0.01). Conclusion: Post-operative epidural analgesia can alleviate the affects of operation and anesthesia stress on erythrocyte immunity and it's adjusting factors.