摘要
目的:探讨右美托咪定(DEX)对结肠癌根治术患者围术期血小板活性和免疫功能的影响。方法:选取行结肠癌根治术患者60例,采用随机数字表法分为DEX组和对照组各30例。DEX组患者于麻醉诱导前10min静脉泵注DEX负荷剂量1μg/kg,随后以0.5μg·kg-1·h-1的速率静脉输注至术毕;对照组患者给予等容量和速率的0.9%氯化钠注射液。比较两组患者麻醉诱导前5min(T0)、手术结束即刻(T1)、术后12h(T2)、术后24h(T3)时的P-选择素(CD62P)、血小板膜糖蛋白(GP)Ⅱb/Ⅲa及Ig M、Ig G、Ig A、CD3+、CD4+、CD8+、CD4+/CD8+水平,并记录两组患者不良反应发生情况。结果:T0时,两组患者CD62P、GPⅡb/Ⅲa及Ig M、Ig G、Ig A、CD3+、CD4+、CD8+、CD4+/CD8+比较,差异均无统计学意义(P>0.05)。T1、T2、T3时,两组患者的CD62P、GPⅡb/Ⅲa较T0时均明显升高,且对照组显著高于DEX组,差异均有统计学意义(P<0.05)。T1、T2、T3时,DEX组患者的Ig M、Ig G、Ig A、CD3+、CD4+、CD8+、CD4+/CD8+与T0时比较,差异均无统计学意义(P>0.05);对照组患者的Ig M、Ig G、Ig A、CD3+、CD4+、CD4+/CD8+与T0时比较明显降低,且显著低于DEX组(P<0.05);CD8+明显升高,且显著高于DEX组(P<0.05)。两组患者不良反应发生率比较,差异无统计学意义(P>0.05)。结论:DEX可抑制结肠癌根治术患者围术期血小板过度活化,并能有效稳定此类患者围术期的免疫功能,且不增加不良反应,对防治结肠癌根治术患者围术期肿瘤细胞血行转移具有一定的临床价值。
Objective:To investigate the effect of dexmedetomidine(DEX)on perioperative platelet activity and cellular immunity for patients undergoing colon cancer radical surgery.Methods:60 patients undergoing colon cancer radical surgery were assigned into two groups using random table method:DEX group(n=30)and control group(n=30).DEX group was given intravenous infusion of DEX with loading dose of 1μg/kg 10 min before anesthesia induction,and then at 0.5μg·kg-1·h-1 till completing the surgery;the control group was given intravenous infusion of 0.9%sodium chloride.The levels of P-selection(CD62P),glycoprotein(GP)II b/III a,IgM,IgG,IgA,CD3+,CD4+,CD8+,and CD4+/CD8+at 5 min before anesthesia induction(T0),immediately after the surgery(T1),12h after the surgery(T2),24h after the surgery(T3)were compared between the two groups.And the adverse events of the two groups were compared.Results:There were no differences in the levels of CD62P,GP II b/III a,IgM,IgG,IgA,CD3+,CD4+,CD8+and CD4+/8+at T0 between the two groups(P>0.05).CD62P and GP II b/III at T1,T2 and T3 of the two groups were significantly higher those at T0 and their levels of the control group were significantly higher than those of DEX group(P<0.05).IgM,IgG,IgA,CD3+,CD4+,CD8+and CD4+/8+of the DEX group at T1,T2 and T3 were similar to those at T0.IgM,IgG,IgA,CD3+,CD4+,CD8+and CD4+/8+of the control group at T1,T2 and T3 were significantly lower than those at T0,and lower than those of the DEX group(P<0.05),while the levels of CD8+strongly increased and were higher than those of the control group(P<0.05).There were no difference in the adverse events rates between the two groups(P>0.05).Conclusions:DEX can inhibit platelet hyperactivation and stabilize immune function of patients undergoing radical resection of colon cancer without increasing adverse reactions.It has certain clinical value in preventing and treating perioperative hematogenous metastasis of tumor cells in patients undergoing radical resection of colon cancer.
作者
曹丙玉
许晓群
CAO Bingyu(University of Jinan-Shandong Academy of Medical Sciences,Shandong Jinan 250022,China)
出处
《河北医学》
CAS
2018年第10期1731-1736,共6页
Hebei Medicine
基金
山东省自然科学基金项目
(编号:ZR2018LH011)
山东省医学科学院院级科技计划项目
(编号:2016-16)
关键词
右美托咪定
结肠癌
血小板
免疫
Dexmedetomidine
Colon cancer
Platelet
Immunity
