论文部分内容阅读
目的:评价不同剂量甲强龙对行胸腔镜肺癌根治术患者免疫功能的影响。方法:选择择期行胸腔镜肺癌根治术患者40例,美国麻醉医师学会(American Society of Anesthesiology,ASA)Ⅱ~Ⅲ级,性别不限,年龄65~85岁,采用随机数字表法分为两组(n=20):甲强龙高剂量组(M组)和甲强龙低剂量组(C组)。在麻醉诱导前30 min,M组静脉注射甲强龙1 mg·kg-1,C组静脉注射甲强龙0.5 mg·kg-1。于诱导前(T0)、术毕(T1)、术后24 h(T2)抽取外周静脉血样,采用流式细胞术测定T淋巴细胞亚群CD3~+、CD4~+、CD8~+水平,计算CD4~+/CD8~+比值。结果:与T0时比较,M组T1和T2时CD3~+水平显著降低(P<0.05),CD4~+水平、CD4~+/CD8~+比值有所降低,CD8~+水平有所升高,但是差异无统计学意义(P>0.05);C组T1和T2时CD3~+、CD4~+、CD8~+水平以及CD4~+/CD8~+比值差异无统计学意义(P>0.05)。与C组比较,M组T1和T2时CD3~+水平降低,T2时CD8~+水平显著升高(P<0.05)。结论:麻醉诱导前30min静脉注射1 mg·kg~(-1)的甲强龙对行胸腔镜肺癌根治术患者的免疫功能有一定影响,而麻醉诱导前30 min静脉注射0.5 mg·kg~(-1)的甲强龙对患者的免疫功能无明显影响。
Objective: To evaluate the effect of different doses of methylprednisolone on immune function in patients undergoing thoracoscopic lung cancer radical operation. Methods: Forty patients undergoing thoracoscopic radical resection of lung cancer undergoing elective surgery were enrolled in this study. American Society of Anesthesiology (ASA) Ⅱ ~ Ⅲ, age ranged from 65 to 85 years, were randomly divided into two groups (n = 20): methylprednisolone high dose group (M group) and methylprednisolone low dose group (C group). At 30 min before induction of anesthesia, M group was injected with 1 mg · kg-1 of methylprednisolone, and C group was injected with 0.5 mg · kg-1 of methylprednisolone. Peripheral venous blood samples were collected before induction (T0), at the end of operation (T1) and 24 h after operation (T2). The levels of CD3 +, CD4 + and CD8 + in T lymphocyte subsets were determined by flow cytometry CD4 ~ + / CD8 ~ + ratio. Results: Compared with T0, the level of CD3 + at T1 and T2 in M group was significantly decreased (P <0.05), the level of CD4 ~ + and the ratio of CD4 ~ + / CD8 + decreased and the level of CD8 + increased , But the difference was not statistically significant (P> 0.05). There was no significant difference in the levels of CD3 +, CD4 +, CD8 + and CD4 + / CD8 + between T1 and T2 in group C (P> 0.05) . Compared with group C, the level of CD3 + at T1 and T2 was decreased in group M, and the level of CD8 + at T2 was significantly increased (P <0.05). CONCLUSION: The intravenous administration of 1 mg · kg ~ (-1) methylprednisolone 30 min prior to induction of anesthesia has an effect on the immune function in patients undergoing thoracoscopic lung cancer radical resection, but the intravenous injection of 0.5 mg · kg ~ (-1) -1) methylprednisolone had no significant effect on the patient’s immune function.