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胸科全麻术中地塞米松对IL-8的影响
| 【Abstract】 Objective To study the effects of dexamethasone on plasma cytokine IL-8 levels during elective pneumonectomy undergoing general anesthesia and to observe the possible activation effects of dexamethasone. Methods Twenty-eight patients were randomly assigned into dexamethasone group(n=14) and control group(n=14). The dexamethasone group received continuous infusion of dexamethasone during surgery at a dose of 0.0025mg/(kg·min). Arterial blood samples were obtained before anesthesia,20 min after anesthesia, 1 hoursafter incision,24 hours and 72 hours after surgery to measure the plasma levels of IL-8. Results The plasma levels of IL-8 increased after anesthesia and during surgery in both groups but the increase was significantly less in the dexamethasone group(P＜0.05). The plasma levels of IL-8 returned to the baseline 24 hours after surgery in dexamethasone group and 72 hours after surgery in control group.Conclusion The administration of dexamethasone suppresses the increase of IL-8 during pneumonectomy. 【Key words】 Anesthesia；IL-8；Dexamethasone 本研究于胸科全麻手术中持续静脉输注低剂量地塞米松，观察能否有效抑制促炎细胞因子IL-8水平的升高。 1 资料与方法 1.1 对象与分组 28例择期单侧肺叶切除手术患者，随机分为对照组和实验组，每组14例，术前、术中及术后三天内均未使用任何激素类药及输血。两组间ASA分级、年龄、性别、身高、体重无差异；心、肝、肾功能及红细胞、白细胞、血小板计数、中性分叶细胞、淋巴细胞及单核细胞分类均无差异，见表1。术前两组间的T淋巴细胞亚群和NK细胞活性无差异，见表2。 1.2 方法 术前30 min肌注鲁米那钠0.1 g和阿托品0.5 mg。两组均用安定0.2 mg/kg、异丙酚2.0 mg/kg、芬太尼2 μg/kg、琥珀胆碱1～2 mg/kg快速诱导插管，机械通气，持续吸入1.5%～2.0%异氟醚，静注芬太尼0.05μg/(kg·min),维库溴铵1.0～1.5 μg/(kg·min)维持麻醉。麻醉全程保持各项生命体征于正常范围。两组病人均采用TERUMO TE-312型微量注射泵，对照组输注生理水，实验组输注0.0025 mg/(kg·min)地塞米松，直至手术结束。两组病人均施行左或右桡动脉穿刺置管，于麻醉前、麻醉后20 min、手术开始后1小时、术后24小时、72小时分别抽取动脉血3 ml。血样经离心后取血清保存于-80℃低温冰箱，采用进口试剂盒检测IL-8水平。所有数据用PEMS 2.0和SPSS/PC+(Statistical Package for the Social Science)统计软件进行处理。P＜0.05为有显著性差异。 2 结果两组术前动脉血IL-8水平均无差异，麻醉后20 min至术后三天对照组与实验组均出现明显升高，与术前相比有显著性差异，但实验组升高幅度小于对照组，两组间比较有显著性差异。实验组IL-8水平于术后24小时回复至正常，而对照组则持续升高至术后72小时。IL-8水平改变见表3和图1。 参考文献 |
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