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目的:探讨右美托咪定(Dex)对舌癌患者围术期免疫功能的影响。方法:将ASAⅠ～Ⅱ级拟行舌癌根治全麻择期手术患者30例随机分为右美托咪定组(Dex组)和对照组各15例。全麻诱导前,Dex组持续泵入右美托咪定0.5μg/kg(溶于10 mL生理盐水),对照组静脉持续泵入生理盐水10 mL,均在10 min内完成。以相同药物快速诱导插管,插管后Dex组以Dex、七氟醚、瑞芬太尼维持:对照组以七氟醚、瑞芬太尼维持。分别于T0(诱导前)、T1(切皮前,诱导后20 min)、T2(切皮后,诱导后50min)测定CD3~+、CD4~+、CD8~+、CD4~+/CD8~+及NK细胞比例。结果:两组在T0时间点CD3~+、CD4~+、CD8~+、CD4~+/CD8~+以及NK细胞的分布差异无统计学意义(P>0.05)。Dex组各个时间点CD3~+、CD4~+、CD8+、CD4~+/CD8~+及NK细胞变化不明显。相对于T0时间点,对照组T1、T2时间点CD3~+、CD4~+、CD4~+/CD8~+和NK细胞呈下降趋势,而CD8~+升高。和对照组比较,Dex组在T1、T2时间点CD4~+/CD8~+、NK细胞升高,而CD8~+降低。结论:Dex作为麻醉辅助药物能减轻全麻药物对舌癌患者免疫功能的影响。
Objective: To investigate the effect of dexmedetomidine on perioperative immune function in patients with tongue cancer. Methods: Thirty ASA Ⅰ ~ Ⅱ patients scheduled for operation under general anesthesia for tongue cancer were randomly divided into dexmedetomidine group (Dex group) and control group (n = 15). Before general anesthesia induction, dexmedetomidine 0.5 μg / kg (dissolved in 10 mL of normal saline) was continuously pumped into Dex group, and 10 mL of normal saline was intravenously injected into the control group, all within 10 min. The same drug was used to induce intubation rapidly. After intubation, the Dex group was maintained with Dex, sevoflurane and remifentanil: the control group was maintained with sevoflurane and remifentanil. The levels of CD3 +, CD4 +, CD8 +, CD4 + / CD8 + cells were measured at T0 (before induction), T1 (before incision, 20 minutes after induction) and T2 (50 minutes after induction) And NK cell ratio. Results: There was no significant difference in the distribution of CD3 +, CD4 +, CD8 +, CD4 + / CD8 + and NK cells between the two groups at T0 (P> 0.05). Dex group at each time point CD3 ~ +, CD4 ~ +, CD8 +, CD4 ~ + / CD8 ~ + and NK cells did not change significantly. Compared with T0, CD3 ~ +, CD4 ~ +, CD4 ~ + / CD8 ~ + and NK cells showed a decreasing trend and CD8 ~ + increased at T1 and T2 in control group. Compared with the control group, the percentage of CD4 ~ + / CD8 ~ +, the number of NK cells and the percentage of CD8 ~ + in Dex group at T1 and T2 were decreased. Conclusion: Dex as an auxiliary anesthetic can reduce the effects of general anesthesia on the immune function of patients with tongue cancer.