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目的：探讨不同麻醉方法对胃肠道肿瘤患者围术期外周血T 细胞亚群以及白细胞介素-2（IL-2）的影响。方法：选择胃肠道肿瘤手术患者40 例，随机分为两组。采用单纯全麻者为对照组，采用全麻复合硬膜外麻醉者为治疗组。分别于麻醉前、麻醉后不同时间点抽取静脉血，流式细胞术测定CD4+T 及CD8+T 细胞亚群数量，ELISA 法测定血清IL-2 的浓度。结果：麻醉后两组患者的 CD4+T 细胞、CD4+/CD8+ 比值和血清IL-2 浓度均有所下降，与麻醉前比较差异有统计学意义（P<0.05），治疗组患者的CD4+T 细胞及IL-2 下降程度不如对照组患者明显，且恢复较快，两组间差异有统计学意义（P<0.05）。结论：胃肠道肿瘤患者在麻醉手术后其细胞免疫功能受到不同程度的抑制，但复合麻醉较单纯全麻的免疫抑制效应低且恢复较快。

英文摘要:

Objective: To explore the impact of different ways of anesthesia on T cell subsets and leukocyte interleukin-2 (IL-2) in perioperative peripheral blood of gastrointestinal tumor patients. Methods: 40 surgery patients who selected to have gastrointestinal tumor surgery were randomly divided into two groups, Conterol group using general anesthesia, and Treat group using anesthesia combined with epidural anesthesia. Extracted venous blood at different time points before or after anesthesia. Flow cytometry was applied to detect the amount of CD4+T and CD8+T cell subsets in peripheral blood, and ELISA was adopted to detect the concentration of serum IL-2. Results: The CD4+T cell subsets in peripheral blood, CD4+ /CD8+ ratio and serum IL-2 concentration were decreased after anesthesia in two groups, difference with statistical significance as compared with that of before anesthesia (P<0.05). The levels of CD4+T and IL-2 in patients of Treat Group decreased less than patients of Control Group and restored more quickly (P<0.05). Conclusion: The cell immune function of gastrointestinal tumor patients was inhibited to different degrees during anesthesia. Combined anesthesia made less immunosuppressive effects and faster recovery than general anesthesia.

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