外科危重病人持续输注异丙酚对IL-1β、IL-6、TNF_1-α的影响

Effects of Prolonged Infusion of Propofol on Blood Levels of IL-1b,IL-6 and TNF-1α in Critically iIl Surgical Patients

目的了解外科危重手术病人术后用异丙酚持续镇静对白介素 1 β(IL 1 β) ,白介素 6 (IL 6 ) ,肿瘤坏死因子 (TNF1 α)等细胞因子的影响。方法随机选择 2 0个外科危重手术病人 ,术后均行长达 2d的镇静 ,在镇静开始及 4 8h分别经中心静脉采血检测IL 1 β、IL 6、TNF1 α。结果异丙酚输注前IL 1 β、IL 6和TNF1 α水平分别为 (5 .4± 1 .6 ) ,(1 4 2± 1 1 0 ) ,(9.6± 4 .4 ) pg/ml,输注异丙酚 4 8h后三者水平 [分别为 (6 .7±1 .4 ) ,(1 74± 1 1 5 ) ,(4 6± 38) pg/ml]显著升高 (P <0 .0 5～ 0 .0 1 )。结论术后持续输注异丙酚可刺激促炎细胞因子IL 1 β、IL 6 ,TNF1 α的产生 。

ObjectivesTo investigate the effects of prolonged sedation from postoperative infusion of propofol on the blood levels of cytokines in critically ill surgical patients.MethodsTwenty surgical patients with critical illness were selected randomly to give postoperative sedation as long as for two days. Blood samples were drawn from their central veins for detection of interleukin 1b (IL 1β), interleukin 6 (IL 6) and tumor necrosis factor 1 α(TNF 1 α) at the beginning of the sedation and 48 h after propofol infusion.ResultsThe blood levels of IL 1b,IL 6 and TNF 1 a after propofol infusion for 48 h[(6.7±1.4),(174±115),(46±38) pg/ml ] increased significantly higher than those before infusion [(5.4±1.6),(142±110),(9.6±4.4) pg/ml ] (P<0.05～0.01) , The rates of elevation were 24%(IL 1β), 23%(IL 6) and 4.8 times(TNF 1 α), respectively .ConclusionProlonged postoperative infusion of propofol can stimulate the production of inflammation promoting cytokines- IL 1β,IL 6 and TNF1α.Therefore, propofol may exert an adverse effect in critically ill and immunodepressed patients.