星状神经节阻滞对老龄大鼠围术期细胞免疫功能的影响

Effect of stellate ganglion block on perioperative cellular immune function in aged rats

目的探讨星状神经节阻滞对老龄大鼠围术期细胞免疫功能的影响.方法健康雄性清洁级老年SD大鼠72只,随机分为3组:正常对照组(C组)、手术组(O组)和颈交感神经干离断+手术组(T组),每组24只.T组于右侧距颈上交感神经节下3mm处离断颈交感神经干,C组和O组仅暴露右侧颈交感神经干和颈上交感神经节,不离断颈交感神经干.操作结束后15min时O组和T组实施剖腹探查术,手术维持30min.各组分别于术前(T0)、术后1d(T1)、术后3d(T2)和术后7d(T3)取6只大鼠,采集外周静脉血测定血糖,高效液相色谱法测定血浆NE浓度,放射免疫法测定血浆Cor浓度,ELISA法测定血清IL-2、IL-6和TNF-α浓度,流式细胞术测定外周血CD4+、CD8+T细胞细胞百分比,并计算CD4+/CD8+比值;处死大鼠,解剖分离胸腺,称重,计算胸腺指数:[胸腺重量(mg)/大鼠重量(g)].结果与C组比较,O组和T组T1-3时血糖、NE、Cor、IL-6、TNF-α及CD8+T水平升高(P<0.05),IL-2、CD4+、CD4+/CD8+比值及胸腺指数水平下降(P<0.05);与O组比较,T组T1-3时血糖、NE、Cor、IL-6、TNF-α及CD8+T水平下降(P<0.05),IL-2、CD4+、CD4+/CD8+比值及胸腺指数水平升高(P<0.05).结论星状神经节阻滞可有效提高老龄大鼠围术期细胞免疫功能,其机制可能与减轻围术期机体应激反应有关.

Objective To investigate the effect of stellate ganglion block on perioperative cellular immune function in aged rats. Methods 72 healthy male clean-grade aged Sprague-Dawley rats were randomly divided into 3 groups: Normal control group(C group), operation group(O group) and cervical sympathetic trunk disconnection + surgery group(T group), 24 rats per group. In the T group, the cervical sympathetic trunk was removed 3 mm below the cervical sympathetic ganglia. The C and O groups only exposed the right cervical sympathetic trunk and the cervical sympathetic ganglia, and did not leave the cervical sympathetic trunk. 15 minutes after the operation, the O group and the T group were subjected to laparotomy, and was maintained for 30 minutes. Six rats were taken in each group before operation(T0), 1 day after surgery(T1), 3 days after surgery(T2) and 7 days after surgery(T3). Peripheral venous blood was collected for blood glucose measurement, plasma NE concentration was determined by high performance liquid chromatography, plasma Cor concentration was determined by radioimmunoassay, serum IL-2, IL-6 and TNF-α concentrations were determined by ELISA, and peripheral blood CD4+ T cell percentage and CD8+ T cell percentage was determined by flow cytometry, then calculate the CD4+/CD8+ ratio. The rats were weighed before sacrifice, and the rats were sacrificed to obtain the thymus which was weighed. The thymus index(thymus weight/body weight) was calculated. Results Compared with group C, blood glucose, NE, Cor, IL-6, TNF-α, and CD8+T levels were increased in group O and group T at T1-3(P<0.05), IL-2, CD4+, the ratio of CD4+/CD8+ ratio and thymus index decreased(P<0.05). Compared with group O, blood glucose, NE, Cor, IL-6, TNF-α, and CD8+T levels decreased in group T at T1-3(P<0.05), IL-2, CD4+, CD4+/CD8+ ratio and thymus index level increased (P<0.05). Conclusion Stellate ganglion block can effectively improve the perioperative cellular immune function in aged rats, and its mechanism may be related to the reduction of perioperative stress response.