摘要
目的 探讨乌司他丁对腹腔镜手术患者术后外周血效应性T淋巴细胞（Teff细胞）和调节性T淋巴细胞（Treg细胞）免疫功能的影响.方法 择期行腹腔镜手术的不孕症患者40例,年龄20～ 40岁,体重45 ～ 65 kg,ASA分级Ⅰ或Ⅱ级,采用随机数字表法,将其分为2组（n=20）：对照组（C组）和乌司他丁组（U组）.麻醉诱导前15 min,U组静脉输注乌司他丁20万U（溶于生理盐水100 ml）,C组给予等量生理盐水.静脉注射芬太尼、丙泊酚和颀式阿曲库铵行麻醉诱导,静脉输注丙泊酚,吸入七氟醚维持麻醉.于术前（T0）、术毕（T1）、术后1 d（T2）、术后3 d（L）采集外周静脉血样,采用流式细胞仪测定Teff细胞（CD4＋ CD25-）和Treg细胞（CD4＋ CD25＋）的表达,并采用ELISA法测定血清干扰素-γ（IFN-”、转化生长因子-β（TGF-β）的浓度,计算Teff/Treg比值、IFN-γ/TGF-β比值.结果 与T0时比较,C组T2和L时Treg细胞表达升高,Teff/Treg比值降低,U组L时Teff细胞表达升高（P＜0.05或0.01）,Treg细胞表达和Teff/Treg比值差异无统计学意义（P＞0.05）;与C组比较,U组T3时Teff细胞表达升高,T2和T3时Treg细胞表达降低,Teff/Treg比值升高,T2,3时血清TGF-β浓度降低,IFN-γ/TGF-β比值升高（P＜0.05或0.01）.2组患者血清IFN-γ 、TGF-β浓度及IFN-γ/TGF-β比值各时点比较差异无统计学意义（P＞0.05）.结论 乌司他丁可增强外周血Teff细胞免疫功能,降低Treg细胞免疫功能,维持腹腔镜手术患者术后细胞免疫功能的平衡.
Objective To investigate the effect of ulinastatin on the postoperative immune function of effective T-lymphocytes （Teff cells） and regulatory T-lymphocytes （Treg cells） in the peripheral blood in patients undergoing laparoscopic operation.Methods Forty ASA physical status Ⅰ or Ⅱ patients,aged 20-40 yr,weighing 45-65 kg,scheduled for elective laparoscopic operation for infertility,were equally and randomly divided into 2 groups using a random number table：control group （group C） and ulinastatin group （group U）.At 15 min before induction of anesthesia,ulinastatin 200,000 U （in 100 ml of normal saline） was infused intravenously in group U,while the equal volume of normal saline was infused instead in group C.Anesthesia was induced with iv injection of fentanyl,propofol,and cisatracurium and maintained with iv infusion of propofol and sevoflurane.Before surgery （T0）,at the end of surgery （T1） and on 1st and 3rd days after surgery （T2.3）,venous blood samples were collected from the peripheral blood for determination of the expression of Teff cells （CD4 ＋ CD25-） and Treg cells （CD4 ＋ CD25＋） and serum interferon-γ （IFN-γ） and transforming growth factor-β （TGF-β） concentrations （by ILISA）.Teff/Treg and IFN-γ/TGF-β ratios were calculated.Results Compared with the baseline value at T0,the expression of Treg cells was significantly up-regulated,and Teff/Treg ratio was decreased at T2 and T3 in group C,and the expression of Teff cells was up-regulated at T3 （P ＜ 0.05 or 0.01）,while no significant difference was found in the expression of Treg cells and Teff/Treg ratio at T3 in group U （P ＞ 0.05）.Compared with group C,the expression of Teff cells was significantly up-regulated at T3,the expression of Treg cells was down-regulated and Teff/Treg ratio was increased at T2 and T3,the concentration of serum TGF-β was decreased and IFN-γ/TGF-β ratio was increased at T2 and T3 in group U （P ＜ 0.05 or 0.01）.No significant changes were found in
出处
《中华麻醉学杂志》
CAS
CSCD
北大核心
2013年第10期1168-1170,共3页
Chinese Journal of Anesthesiology
基金
2010年天普研究基金（01201033）
