文章摘要
潘熊熊,毛琛璐,张晓坤,钱燕宁.不同麻醉和镇痛方法对食管癌开胸手术患者外周血Th细胞分化的影响[J].南京医科大学学报,2008,28(6):790~793797
不同麻醉和镇痛方法对食管癌开胸手术患者外周血Th细胞分化的影响
The effects of anesthesia and postoperative analgesia with different methods on the differentiation of human helper T cells in the esophageal carcinoma patients undergoing thoracic surgery
投稿时间:2007-10-17  
DOI:10.7655
中文关键词: 麻醉方法  镇痛  胸段硬膜外麻醉  Th细胞分化
英文关键词: anesthesia method  analgesia  thoracic epidural anesthesia  differentiation of helper T cells
基金项目:江苏省卫生厅医学科技发展基金(2007H05)
作者单位
潘熊熊 南京医科大学第一附属医院麻醉科,江苏 南京 210029 
毛琛璐  
张晓坤  
钱燕宁  
摘要点击次数: 1370
全文下载次数: 155
中文摘要:
      目的:观察不同麻醉和镇痛方法对食管癌开胸手术患者外周静脉血辅助性T细胞分化的影响?方法:60例ASAⅠ~Ⅱ级择期食管癌开胸手术患者随机均分为3组:Ⅰ组采用全凭静脉麻醉,术后行患者自控静脉镇痛(PCIA);Ⅱ组采用胸段硬膜外阻滞复合静脉全麻,术后行PCIA;Ⅲ组麻醉方法同Ⅱ组,术后行患者自控硬膜外镇痛(PCEA)?3组分别于麻醉前(T0),切皮后2 h(T1),术后4 h(T2),术后24 h(T3),术后48 h(T4)抽取肘静脉血,用流式细胞检测技术测定Th1?Th2细胞胞内因子γ-干扰素(IFN-γ)?IL-4的水平,用CD3+CD8-IFN-γ+标识Th1细胞,用CD3+CD8-IL-4+标识Th2细胞,通过计算IFN-γ+%/IL-4+%来测Thl/Th2值?结果:与T0时比较,Ⅰ组Thl/Th2值在T2时明显降低(P < 0.05),Ⅱ?Ⅲ组在T3时Thl/Th2值均明显降低(P < 0.05)?组间比较,Ⅱ?Ⅲ组Thl/Th2值在T2时高于Ⅰ组,Ⅲ组Thl/Th2值在T3和T4时均高于Ⅱ组?结论:食管癌开胸手术患者术后皆出现Thl/Th2值的降低;硬膜外阻滞复合静脉全麻辅以术后硬膜外镇痛能够抑制Th0细胞向Th2细胞的过度分化?
英文摘要:
       Objective:To investigate the effects of anesthesia and postoperative analgesia with different methods on the differentiation of human helper T cells in the esophageal carcinoma patients undergoing thoracic surgery. Methods:Sixty esophageal carcinoma patients,classified as ASA physical status Ⅰ~Ⅱ,scheduled for elective thoracic surgery were randomly divided into three groups with 20 cases in each group:groupⅠreceived general anesthesia during thoracic surgery and patient-controlled intra-venous analgesia(PCIA) with fentanyl postoperatively;groupⅡunderwent general anesthesia plus thoracic epidural anesthesia(TEA) during thoracic surgery and received the same analgesia method as groupⅠpostoperatively; group Ⅲ were anesthetized as groupⅡ and received patient-controlled epidural analgesia(PCEA) with fentanyl and ropivacaine postoperatively. Venous blood samples for measurement of IFN-γ(as a marker of Thl cells) and IL-4(as a marker of Th2 cells)were taken before the induction of anesthesia and at set intervals until 48 h postoperatively. T helper cell subsets were quantified by using flow cytometry,and the ratio of Thl to Th2 cells was calculated. Results:The analgesial effects were similar among the groups. The Thl/Th2 ratio in all groups were decreased significantly after completion of surgery compared with baseline levels(P < 0.05). Group comparison,at T2 the Thl/Th2 ratio in GroupⅡ and Ⅲ higher than that in groupⅠ. In group Ⅲ the Thl/Th2 ratio at T3 and T4,were higher than those in groupⅡ. Conclusion:These findings show that general anesthesia combined with thoracic epidural anesthesia and PCEA may inhibit Th0 cells to differentiate into Th2 cells.
查看全文   查看/发表评论  下载PDF阅读器
关闭