腹腔镜阑尾切除术前应用吲哚美辛栓和氯诺昔康对免疫功能影响的比较

Effect of indomethacin suppository and lornoxicam on immune function before laparoscopic appendectomy

目的探讨吲哚美辛栓和氯诺昔康在腹腔镜阑尾切除术(LA)前应用对免疫功能的影响。方法收集2022年3月至4月50例急诊全身麻醉下行LA患者病例资料,采用随机数字表法将患者分为两组:A组患者(n=25例)术前30min予吲哚美辛栓100mg直肠单次给药,B组患者(n=25例)术前30min予氯诺昔康8mg静脉滴注。采用SPSS26.0统计软件进行数据分析。淋巴细胞亚群指标、炎症因子指标等定量资料以(x±s)表示,组间采用独立t检验;术后不良反应发生率采用X检验。P<0.05为差异有统计学意义。结果两组患者术后1d与术前相比,A组肿瘤坏死因子(TNF-α)、白细胞介素-6(IL-6)、白细胞介素-8(IL-8)、白细胞介素-10(IL-10)降低(P<0.05),B组差异无统计学意义(P>0.05)。A组患者术后CD4^(+)CD25^(+)T细胞、CD4^(+)Foxp3^(+)T细胞、CD25^(+)Foxp3^(+)T细胞比例较术前增加(P<0.05),B组CD4^(+)Foxp3^(+)T细胞比例比术前减少(P<0.05),两组其余淋巴细胞亚群细胞比例术后与术前相比,差异无统计学意义(P>0.05)。结论LA术前应用吲哚美辛栓较氯诺昔康可增加患者术后Foxp3^(+)调节性T细胞(Foxp3^(+)Treg),降低TNF-α、IL-6、IL-8、IL-10水平,增强患者的免疫储备能力,有利于减轻围手术期应激反应。

Objective To investigate the effect of indomethacin supposal and lornoxicam on immune function before laparoscopic appendectomy(LA).MethodsFifty patients with LA under emergency general anesthesia from March to April 2022 were collected and divided into two groups by random number table method:Group A was given a single rectal administration of indomethacin embolus 100mg 30min before surgery,and group B was given an intravenous infusion of lornoxicam 8mg 30min before surgery.SPSS26.0 statistical software was used for data analysis.Quantitative data such as lymphocyte subgroup index and inflammatory factor index were expressed as(x±s).Independent t test was used between groups.The incidence of postoperative adverse reactions was Chi-square test,and P<0.05 was considered statistically significant.Results 1 day after surgery,tumor necrosis factor(TNF-α),interleukin-6(IL-6),interleukin-8(IL-8)and interleukin-10(IL-10)in group A were decreased(P<0.05),while there was no statistical significance in group B(P>0.05).The proportions of CD4^(+)CD25^(+)T cells,CD4^(+)Foxp3^(+)T cells and CD25^(+)Foxp3^(+)T cells in group A after surgery were increased compared with those before surgery(P<0.05),while the proportions of CD4^(+)Foxp3^(+)T cells in group B were decreased compared with those before surgery(P<0.05).The proportions of other lymphocyte subsets in the two groups after surgery were compared with those before surgery.The difference was not statistically significant(P>0.05).ConclusionCompared with lornoxicam,intometin supposit before LA can increase Foxp3^(+)Treg,reduce TNF-α,IL-6,IL-8 and IL-10 levels,enhance the immune reserve capacity of patients,and help alleviate perioperative stress response.