摘要
目的探讨丙泊酚和七氟醚麻醉对胃癌患者围术期T淋巴细胞与血清肿瘤性标志物的影响。方法选择2016年6月-2017年6月在新疆医科大学附属肿瘤医院准备择期在腹腔镜下行胃癌根治手术的患者40例,ASA分级为Ⅰ～Ⅱ级,随机分成丙泊酚组(P组,n=20例)和七氟醚组(S组,n=20例),丙泊酚组用TCI靶控泵注,七氟烷组持续吸入。于诱导前(T0)、手术开始30min(T_1)、术毕(T_2)、术后1d(T_3)和术后3d(T_4),使用流式细胞仪检测T淋巴细胞亚群CD^(3+)、CD^(4+)、CD^(8+)、CD^(4+)/CD^(8+)比率和CD^(4+)CD25^+调节性T细胞(Treg)水平;其次于诱导前(T_0)、术毕(T_2)、术后3d(T_4)和术后7d(T_5)时点,使用Swiss Roche ELECSY 2010化学发光免疫测定法测定CEA、CA19-9、CA72-4的表达,比较2组各项指标的差异。结果 (1)2组患者在各个时间点的CD^(3+)、CD^(4+)、CD^(8+)、CD^(4+)/CD^(8+)和Treg指标水平比较,差异均无统计学意义(P>0.05)。七氟醚组T_2、T_3、T_4时点的CD^(3+)水平与T_0比较,差异有统计学意义(P <0.05);丙泊酚组T_1和T_2、七氟醚组T_1时点的CD^(4+)水平与T0比较,差异有统计学意义(P <0.05);丙泊酚组T4、七氟醚组T_1和T_3时点的CD^(8+)水平与T_0比较,差异有统计学意义(P <0.05);丙泊酚组T_1、T_2和T_4、七氟醚组T_1时点的CD^(4+)/CD^(8+)水平与T_0比较,差异有统计学意义(P <0.05);丙泊酚组T_4、七氟醚组T2时点的Treg水平与T_0比较,差异有统计学意义(P <0.05)。(2)2组患者在各个时间点的血清CEA、CA199、CA724表达水平比较,差异均无统计学意义(P>0.05)。结论在临床剂量范围内,丙泊酚和七氟醚2种麻醉药物对患者免疫功能的影响未见明显差异。
Objective To compare the effects of propofol and sevoflurane anesthesia on T lymphocyte and serum tumor markers in patients with gastric cancer during perioperative period.Methods From June 2016 to June 2017,40 patients with gastric cancer who were scheduled for laparoscopic radical gastrectomy in the Affiliated Tumor Hospital of Xinjiang Medical University were randomly divided into propofol group(P group,n 20 cases)and sevoflurane group(S group,n 20 cases).The propofol group was given TCI target-controlled infusion and sevoflurane group was inhaled continuously.Flow cytometry was used to detect T lymphocyte subsets CD3+,CD4+,CD8+,CD4+/CD8+ratio and CD4+CD25+regulatory T cell(Treg)levels at the times of pre-induction(T0),30 minutes of operation beginning(T1),operation ending(T2),1 day of post-operation(T3)and 3 days of post-operation(T4),and the expressions of CEA and CA19-9,CA72-4 were detected by Swiss Roche ELECSY 2010 chemiluminescence immunoassay at the times of pre-induction(T0),operation ending(T2),3 days of post-operation(T4)and 7 days of post-operation(T5),and the differences of the parameters between the two groups were compared.Results(1)There was no significant difference in the levels of CD3+,CD4+,CD8+,CD4+/CD8+and Treg at each time point between the two groups(P>0.05).The CD3+levels at T2,T3 and T4 in the sevoflurane group were significantly higher than those at T0(P<0.05);the CD4+levels at T1 and T2 in the propofol group and at T1 in the sevoflurane group were significantly higher than those at T0(P<0.05);the CD8+levels at T4 in the propofol group and at T1 and T3 in the sevoflurane group were significantly higher than those at T0(P<0.05);the CD4+/CD8+levels at T1,T2 and T4 in the propofol group and at T1 in the sevoflurane group were significantly higher than those at T0(P<0.05);the Treg levels at T4 in the propofol group and at T4 in the sevoflurane group were significantly higher than those at T0(P<0.05).(2)There was no significant difference in the levels of serum CEA,CA199 and CA724 between t
作者
陈杰
闫睿
雷钟
程真珍
严竣英
帕提曼.帕拉提
张冰
CHEN Jie;YAN Rui;LEI Zhong;CHENG Zhenzhen;YAN Junying;Patiman Palati;ZHANG Bing(Department of Anesthhesiology,Affiliated Tumor Hospital,Xinjiang Medical University,Urumqi 830011,China)
出处
《新疆医科大学学报》
CAS
2019年第2期186-190,共5页
Journal of Xinjiang Medical University
基金
新疆维吾尔自治区自然科学基金医学联合基金(2015211C135)
