右美托咪定对肺癌根治术患者炎性反应和免疫功能的影响

Effects of Dexmetomidine on Inflammatory,Response and Immune Function in Patients Undergoing Radical Resection of Lung Cancer

目的探讨右美托咪定对肺癌根治术患者炎性反应和免疫功能的影响。方法选取深圳市龙华区中心医院于2016年7月—2017年6月收治的98例择期全麻下行肺癌根治术患者,按随机数字表法分为2组,每组59例,在麻醉诱导前,观察组静脉输注1.0μg/kg右美托咪啶,时间为10 min,随后改为0.5μg/(kg·h),直至手术完成;对照组采用与观察组相同方法静脉输注生理盐水(等量)。分别于麻醉诱导开始时(T0)、手术结束即刻(T1)及术后12h(T2),取5 ml肘静脉血,测定总T淋巴细胞、抑制性T细胞(Ts)及辅助性T细胞(Th)。另测定细胞介素-10(IL-10)、白细胞介素-6(IL-6)及血清肿瘤坏死因子(TNF-α)的浓度。结果观察组T1时CD4+、CD8+、CD4+/CD8+及T2时的CD4+相比对照组,差异有统计学意义。相比对照组,观察组T2～T4时,IL-6、TNF-α浓度有明显降低,IL-10浓度升高。结论肺癌根治术患者采用右美托咪定,能减轻其炎性反应,改善免疫功能。

Objective To investigate the effect of dexmetomidine on inflammatory response and immune function in patients undergoing radical resection of lung cancer. Methods 98 patients with lung cancer treated in the hospital from July, 2016 to June, 2017 were randomly divided into two groups, with 59 cases in each group. Before anesthesia induction, the observation group received intravenous infusion of dexmetidine 1.0 μg/kg. The time was 10 minutes,then changed to 0.5 μg(/ kg · h),until the operation was completed. And the control group received the same method of intravenous infusion of normal saline(equal volume)as the observation group. At the beginning of anesthesia induction(T0),the end of operation(T1)and 12h after operation(T2),the blood samples of 5mL cubital vein were collected,and the total T lymphocytes,inhibitory T cell(Ts)and helper T cell(Th)were measured. The concentrations of interleukin-10(IL-10),interleukin-6(IL-6)and serum tumor necrosis factor(TNF-α)were measured. Results CD4^+,CD8^+,CD4^+/CD8 and CD4^+ at T2 were significantly higher in the observation group than in the control group(P<0.05). Compared with the control group,the concentration of IL-6 and TNF-α decreased significantly in the observation group at T2~T4. The concentration of IL-10 increased. Conclusion Dexmetomidine can alleviate inflammatory reaction,and improve immune function in patients with lung cancer.