| 李秀艳,白文娅,滕秀飞,杨延超,李 阳,朱俊超.不同剂量甲强龙对行胸腔镜肺癌根治术患者免疫功能的影响[J].,2017,17(28):5453-5456 |
| 不同剂量甲强龙对行胸腔镜肺癌根治术患者免疫功能的影响 |
| Effects of Different Doses of Methylprednisolone on the Immune Function of Patients undergoing Radical Resection of Pulmonary Carcinoma Performed via Video-assisted Thoracoscope |
| 投稿时间：2017-03-28 修订日期：2017-04-20 |
| DOI：10.13241/j.cnki.pmb.2017.28.012 |
| 中文关键词: 甲强龙 免疫功能 肺癌 胸腔镜 |
| 英文关键词: Methylprednisolone Immunological function Lung cancer Thoracoscope |
| 基金项目:辽宁省自然科学基金项目（20102282）；中国医科大学盛京医院三新项目（2016PS122J） |
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| 中文摘要: |
| 摘要 目的：评价不同剂量甲强龙对行胸腔镜肺癌根治术患者免疫功能的影响。方法：选择择期行胸腔镜肺癌根治术患者40例，美国麻醉医师学会(American Society of Anesthesiology，ASA)Ⅱ~Ⅲ级，性别不限，年龄65~85 岁，采用随机数字表法分为两组(n = 20)：甲强龙高剂量组(M组)和甲强龙低剂量组(C组)。在麻醉诱导前30 min，M组静脉注射甲强龙1 mg?kg-1, C组静脉注射甲强龙0.5 mg?kg-1。于诱导前(T0)、术毕(T1)、术后24 h(T2)抽取外周静脉血样，采用流式细胞术测定T淋巴细胞亚群CD3+、CD4+、CD8+水平，计算CD4+／CD8+比值。结果：与T0时比较，M组T1和T2时CD3+水平显著降低(P < 0.05)，CD4+水平、CD4+/CD8+比值有所降低，CD8+水平有所升高，但是差异无统计学意义(P>0.05)；C组T1和T2时CD3+、CD4+、CD8+水平以及CD4+/CD8+比值差异无统计学意义(P>0.05)。与C组比较，M组T1和T2时CD3+水平降低，T2时CD8+水平显著升高(P < 0.05)。结论：麻醉诱导前30 min静脉注射1 mg?kg-1的甲强龙对行胸腔镜肺癌根治术患者的免疫功能有一定影响，而麻醉诱导前30 min静脉注射0.5 mg?kg-1的甲强龙对患者的免疫功能无明显影响。 |
| 英文摘要: |
| ABSTRACT Objective: To evaluate the effects of different doses of methylprednisolone on the immune function of patients undergoing radical resection of pulmonary carcinoma performed via video-assisted thoracoscope. Methods: Forty patients of both gender, aged 65-85 yr, American Society of Anesthesiologists physical status II-III, scheduled for radical resection of pulmonary carcinoma performed via video-assisted thoracoscope under general anesthesia were randomly divided into two groups (n = 20 each): high-dose of methylprednisolone group (group M) and low-dose of methylprednisolone (group C). At 30 minutes prior to the induction of anesthesia, methylprednisolone 1 mg?kg-1 was injected intra-venously in group M, and 0.5 mg?kg-1 was injected intra-venously in group C. Before the induction of anesthesia (T0), immediately after surgery (T1), at 24 h after surgery (T2), the venous blood samples were collected to detect the levels of T lymphocyte subsets CD3+，CD4+ and CD8+ (by flow cytometry)．CD4+/CD8+ ratio was calculated. Results: Compared with the values at T0, the levels of CD3+ was decreased at the time points of T1 and T2 (P<0.05), the levels of CD4+, and the ratio of CD4+/CD8+ were decreased, the level of CD8+ was increased, but there was no significant difference compared with the values at T0 in group M (P < 0.05), and no significant change was found in the levels of CD3+, CD4+, CD8+ and the ratio of CD4+/CD8+ in group C(P < 0.05). Compared with the group C, the levels of CD3+ were decreased at the time points of T1 and T2, and the level of CD8+ was increased at the time points of T2 (P < 0.05). Conclusion: Methylprednisolone injected intravenously at a dose of 1 mg/kg 30 mins before the induction of anesthesia could exert negative influence on the immune function of patients undergoing radical resection of pulmonary carcinoma performed via video-assisted thoracoscope, while no significant influence occurred when 0.5 mg?kg-1 was given. |
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