术中高浓度氧对患者细胞因子及涎液化糖链蛋白6水平的影响

The effect of high concentration oxygen on the level of cytokines and slg-6 in patients during operation

目的探讨高浓度氧通气对全身麻醉手术患者血清涎液化糖链蛋白6(krebs von den lungen 6,KL-6)及细胞因子表达的影响。方法经医院伦理学会批准,选取重庆市巴南区人民医院2018年1月2018年6月行全身麻醉手术者96例,按照随机数字表法分为A组(100%氧吸入)和B组(60%氧吸入),每组48例。分别于全身麻醉前30 min(T0)、全身麻醉后60 min(T1)、全身麻醉后120 min(T2)、全身麻醉后180 min(T3)、机械通气结束后60 min(T4)抽取桡动脉血行动脉血气分析。并于T0、T1、T2.T3及T4时间点抽取中心静脉血,检测血清KL-6、肿瘤坏死因子-a(TNF-x)、白细胞介素-8(IL-8)水平。结果两组患者全身麻醉前血清KL-6.TNF-α、IL-8组间比较差异无统计学意义(P>0.05)。全身麻醉后血清KL-6、TNF-α、IL-8均逐渐上升,其中A组T1血清KL-6、TNF-α、IL-8即显著高于T0[KL-6(U/mL):173.22±31.19比101.13±22.31;TNF-a(pg/mL):5.99±2.81比3.24±1.98;IL-8(pg/mL):128.11±32.21比98.22±19.77,均P<0.05]。B组T1血清KL-6高于T0[KL-6(U/mL):121.64±33.55比99.29±24.93]。T2血清TNF-α、IL-8高于TO0[TNF-a(pg/mL):4.41±2.71比3.24±1.98;IL-8(pg/mL):123.21±31.47比98.22±19.77,均P<0.05]。A组T1-T4血清KL-6、TNF-α.IL-8分别为[KL-6:(173.22±31.19)(189.38±39.11)(236.16±49.37)(210.04±38.66)U/mL;TNF-a(5.99±2.81)(6.21±2.56)(6.92±3.01)(6.31±2.88)pg/mL;IL-8:(128.11±32.21)(155.17±42.19)(188.28±40.33)(171.15±43.11)pg/mL],均高于同时点B组[KL-6:(121.64±33.55>/(141.33±36.74)(168.04±42.55)(166.39±44.63)U/mL;TNF-α(3.31±2.11)(4.41±2.71)(4.50±3.12)(4.39±2.41)pg/mL;IL-8:(103.12±23.3(123.21±31.47)(135.194.33)(137.339.22)pg/mL],差异均有统计学意义(均P<0.05)。结论全身麻醉术中高浓度氧气吸入可引起患者血清细胞因子及KL-6表达增多。

Objective To investigale the effects of hyperoxia on the expression of serum Krebs von den lungen 6(KL-6)and cytokines in the patients with general anesthesia under.Methods Upon the approval of hospital ethic comittee,72 pa-tients with general anesthesia in People's Hospital of Ba'nan District from January 2018 to June 2018 were divided into group A(FiO2100%)and group B(FiO260%)according to the random number table method,with 48 cases in each group.Arterial blood gas analysis was performed at these points:30 min before general anesthesia(T0),60 min after general anes-thesia(T1),120 min after general anesthesia(T2),180 min after general anesthesia(T3)and end of mechanical ventilation 60 min(T4).Central venous blood was sampled at T0,T1,T2,T3 and T4 for the determination of serum KL-6,TNF-αnd IL-8 by enzyme-linked immunosorbent assay.Results The levels of serum KL-6,TNF-α,1L-8 were no significantly differ-ence between the two groups before general anesthesia.After general anesthesia,the levels of KL-6,TNF-x.IL-8 in both groups were gradually increased.Among them,KL-6,TNF-cand IL-8 at T1 were significantly higher than those of T0 in the group A[KL-6(U/mL):173.22±31.19 vs.101.13±22.31.TNF-α(pg/m1D):5.99±2.81 vs.3.24±1.98,IL-8(pg/mL):128.11±32.21 vs.98.22土19.77,all P<0.05].KL-6 at T1 was significantly higher than that of TO in the group B[KL-6(U/mL):121.64±33.55 vs.99.29±24.93,P<0.05].TNF-α,IL-8 at T2 were significantly higher than those of T0 in the group B[TNF-α(pg/mL):4.41±2.71 v8.3.24±1.98,L-8(pg/mL);123.21±31.47 vs.98.22±19.77,all P<0.05].The serum KL-6,TNF-α,IL-8 of group A at TI^4 were[KL-6(173.22±31.19)(189.38±39.11)(236.16±49.37)(210.04±38.66)U/mL,TNF-a(5.99±2.81)(6.21±2.56)(6.92±3.01)(6.31±2.88)pg/ml,IL-8(128.11±32.21)(155.17±42.19)(188.28±40.33)(171.15±43.11)pg/mL]J which were significantly higher than group B[KL-6(121.64±3.5)5(141.33±36.74).(168.04±42.55)(166.39±44.63)U/mL,TNF-α(3.31±2.11)(4.41±2.71)(4.50±3.12)(4.39±2.41)pg/mL,L.-8(103.12±23.33)(123.21±31.47)(135.1941.33).(137.33±39.22)pg/mL].the diferences were statistically significant(all P<0.05).Conclusion High concentration oxygen inhalation during general anesthesia can increase the expression of serum cytokines and KL-6.