地佐辛复合麻醉对腹腔镜结肠癌手术患者血清GSH、CAT、MDA、SOD、TNF-α、CRP、IL-6及T淋巴细胞亚群水平的影响

Effects of dezocine combined with anesthesia on serum GSH,CAT,MDA,SOD,TNF-α,CRP,IL-6 and T lymphocyte subsets in patients after laparoscopic surgery for colon cancer

目的:探讨地佐辛复合麻醉对腹腔镜结肠癌手术患者血清谷胱甘肽(glutathione,GSH)、过氧化氢酶(catalase enzymes,CAT)、丙二醛(malondialdehyde,MDA)、超氧化物歧化酶(superoxide dismutase,SOD)、肿瘤坏死因子-α(tumor necrosis factor-α,TNF-α)、C反应蛋白(C-reactive protein,CRP)、白细胞介素-6(interleukin-6,IL-6)及T淋巴细胞亚群水平的影响。方法:选择我院收治的拟行腹腔镜结肠癌根治术的120例患者,随机分为对照组和实验组,各60例。对照组采用瑞芬太尼复合麻醉,实验组采用地佐辛复合麻醉。检测并比较两组患者手术前后血清GSH、CAT、MDA、SOD、TNF-a、CRP、IL-6水平及外周血CD3^+、CD4^+、CD8^+水平及CD4^+/CD8^+。结果:两组手术前的血清GSH、CAT、MDA、SOD水平比较,差异均无统计学意义(P>0.05);两组手术后的血清GSH、CAT、SOD水平相比手术前均较低、血清MDA水平相比手术前均较高,且实验组手术后血清GSH、CAT、MDA、SOD水平变化均优于对照组,具有显著性差异(P<0.05)。两组手术前的血清TNF-α、CRP、IL-6水平比较,差异均无统计学意义(P>0.05);两组手术后的血清TNF-α、CRP、IL-6水平相比手术前均较高,且实验组手术后血清TNF-α、CRP、IL-6水平均低于对照组,具有显著性差异(P<0.05)。两组手术前的外周血CD3^+、CD4^+、CD8^+水平及CD4^+/CD8^+比较,差异均无统计学意义(P>0.05);两组手术后的外周血CD3^+、CD4^+水平及CD4^+/CD8^+相比手术前均较低、CD8^+水平相比手术前均较高,且实验组手术后外周血CD3^+、CD4^+、CD8^+水平及CD4^+/CD8^+变化均优于对照组,具有显著性差异(P<0.05)。结论:地佐辛复合麻醉用于轻腹腔镜结肠癌手术中,能够减轻术后氧化应激反应,降低血清TNF-a、CRP、IL-6等细胞因子水平,且对细胞免疫功能影响较小,值得在临床上推广应用。

Objective:To study the effects of dezocine combined with anesthesia on serum GSH,CAT,MDA,SOD,TNFα,CRP,IL 6 and T lymphocyte subsets in patients after laparoscopic surgery for colon cancer.Methods A total of 120 patients with laparoscopic cholecystectomy in our hospital from January 2014 to January 2017 were enrolled in this study.The subjects were divided into the control group(n=60)and the treatment group(n=60)randomly.The control group were treated with remifentanil combined anesthesia,the treatment group were treated with dezocine combined with anesthesia.The serum GSH,CAT,MDA,SOD,TNF a,CRP,IL 6 and peripheral blood CD3+,CD4+,CD8+,CD4+/CD8+of the two groups before and after surgery were compared.Results There were no significantly differences of the serum GSH,CAT,MDA,SOD of the two groups before surgery(P>0.05).The serum GSH,CAT,SOD of the two groups after surgery were significantly lower than before surgery(P<0.05),the serum MDA of the two groups after surgery were significantly higher than before surgery(P<0.05),and that of the treatment group after surgery were significantly better than the control group(P<0.05).There were no significantly differences of the serum TNFα,CRP,IL 6 of the two groups before surgery(P>0.05).The serum TNFα,CRP,IL 6 of the two groups after surgery were significantly higher than before surgery(P<0.05),and that of the treatment group after surgery were significantly lower than the control group(P<0.05).There were no significantly differences of the peripheral blood CD3+,CD4+,CD8+and CD4+/CD8+of the two groups before surgery(P>0.05).The peripheral blood CD3+,CD4+and CD4+/CD8+of the two groups after surgery were significantly lower than before surgery(P<0.05),the peripheral blood CD8+of the two groups after surgery were significantly higher than before surgery(P<0.05),and that of the treatment group after surgery were significantly better than the control group(P<0.05).Conclusion Dezocine combined with anesthesia can reduce the oxidative stress reaction in patients after laparoscopic surgery for colon cancer,ruduce serum TNF a,CRP,IL 6 levels,has smaller effect on cellular immune function,and it was worthy clinical application.