| 周路阳,顾 伟,刘 芸,杨咏波,王 毅.右美托咪定对脑肿瘤手术患者细胞免疫功能以及预后影响的研究[J].,2017,17(28):5484-5488 |
| 右美托咪定对脑肿瘤手术患者细胞免疫功能以及预后影响的研究 |
| Influence of Dexmedetomidine on Cellular Immune Function and Prognosis in Patients Undergoing Surgery of Brain Tumor |
| 投稿时间：2016-12-27 修订日期：2017-01-12 |
| DOI：10.13241/j.cnki.pmb.2017.28.019 |
| 中文关键词: 右美托咪定 脑肿瘤 细胞免疫 |
| 英文关键词: Dexmedetomidine Brain tumor Cellular immune function |
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| 中文摘要: |
| 摘要 目的：探讨右美托咪定（Dex）对脑肿瘤手术患者细胞免疫功能及预后的影响。方法：选择2013年1月-2016年1月本院60例行脑肿瘤手术的患者，随机分为实验组和对照组，各30例。实验组患者进入手术室后静脉泵入Dex，对照组给予0.9%氯化钠溶液，观察比较两组在手术前（T0）、手术开始后1h（T1）、术后1h（T2）、术后24 h（T3）四个时期的C 反应蛋白（CRP）、T 细胞亚群值、自然杀伤细胞（NK）数量、以及IL-2、IL-6、IL-10 浓度。随访1年观察患者复发情况。结果：实验组T2期的CD3、CD4、CD4/CD8 水平显著低于T0，差异有统计学意义（P＜0.05）。实验组T2期的CD4、CD4/CD8 水平明显高于对照组，差异有统计学意义（P＜0.05）。对照组T2、T3的NK值显著低于T0期，实验组T2时的NK值显著高于对照组，差异有统计学意义（P＜0.05）。两组T1、T2、T3的血清CRP水平显著高于T0，且实验组显著低于对照组，差异均有统计学意义（P＜0.05）。对照组IL-2在T1、T2期的水平显著低于T0期，且实验组显著高于对照组，差异均有统计学意义（P＜0.05）。实验组IL-6在T2、T3期显著低于T0期，对照组IL-6在T1、T2、T3期水平显著低于T0期，且实验组在T1、T2、T3期明显低于对照组。对照组IL-10在T2、T3期高于T0期，且实验组在T2、T3期显著低于对照组，差异均有统计学意义（P＜0.05）。两组1年内总复发率比较，差异有统计学意义（P＜0.05）。结论：脑肿瘤切除手术应激及麻醉可能导致细胞免疫功能下降，Dex可以改善细胞免疫功能，有利于手术患者的康复及预后。 |
| 英文摘要: |
| ABSTRACT Objective: To explore the influence of dexmedetomidine (Dex) on the cellular immune function and prognosis in patients undergoing resection of brain tumor. Methods: 60 patients underwent resection of brain tumor in our hospital from January 2013 to January 2016 were selected and randomly divided into the control group and the observation group, 30 cases in each group. The observation group was given Dex during the anesthesia induction,and the control group was given 0.9% sodium chloride solution. The C reaction protein (CRP) level, T cell subgroup value and natural killer (NK) level, IL-2, IL-6 and IL-10 concentration of the two groups at before resection (T0), 1 h after resection start (T1), 1 h after resection (T2), 24 h after resection (T3) were compared respectively. The patients were followed up for 1year for recurrence. Results: The levels of CD3, CD4, CD4/CD8 in the observation group in T2 were lower than that in T0(P<0.05), and the levels of CD4, CD4/CD8 in observation group were higher than that in the control group in T2, with significant difference(P＜0.05). The value of NK in the control group in T2 and T3 were lower than T0, and the observation group in T2 was higher than control group, with significant difference(P<0.05). The levels of serum CRP in T1, T2, T3 in the two groups were higher than T0(P<0.05), and the observation group were lower than those in the control group(P＜0.05). The levels of IL-2 in control group in T1 and T2 were lower than T0, meanwhile,the observation group were higher than control group at the same time period, with significant difference(P<0.05). The levels of IL-6 in observation group in T2 and T3 were lower than T0, which in control group in T1, T2, T3 were lower than T0, and the observation group in T1, T2 and T3 were lower than control group, with significant difference(P<0.05). The levels of IL-10 in control in T2, T3 were higher than T0, and the observation group were lower than control group at the same time period,with significant difference(P<0.05). The total recurrence rates in two groups 1 year had statistical significance(P<0.05). Conclusion: Brain tumor resection and anesthesia may lead to decreased cellular immune function, which could be improved by Dex, it is conducive to the rehabilitation and prognosis of patients. |
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