不同麻醉方式对腹腔镜前列腺癌根治术患者围术期细胞免疫功能的影响

金楠; 叶少方; 高伟; 赵年章

doi:10.3969/j.issn.1674-4500.2015.02.06

不同麻醉方式对腹腔镜前列腺癌根治术患者围术期细胞免疫功能的影响

doi: 10.3969/j.issn.1674-4500.2015.02.06

1.
广州医科大学附属第五医院麻醉科，广东广州 510700
2.
广州医科大学荔湾医院泌尿外科，广东广州 510145

详细信息

作者简介:
金楠，在职硕士在读，主治医师，E-mail: gzjinnan@yeah.net

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- 文章访问数: 450
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- PDF下载量: 2
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出版历程
- 收稿日期: 2015-03-24
- 刊出日期: 2015-07-02

Application of three dimensional visualization technology for laparoscopic Resection of cystic carcinoma in pancreatic body and tail

1.
Department of Anesthesiology, the Fifth Affiliated Hospital of Guangzhou Medical University, Guangzhou 510700, China
2.
Department of Urology, Liwan Hospital of Guangzhou Medical University, Guangzhou 510145, China

摘要

摘要: 目的探讨不同麻醉方式对腹腔镜前列腺癌根治术患者围术期细胞免疫功能的影响。方法选择18例腹腔镜前列腺癌根治术患者, 随机分为两组：全凭静脉麻醉组（A组）和静脉全麻复合腰硬联合麻醉组（B组），每组9例。分别于麻醉前1 h（T0）、麻醉后1 h（T1）、术后24 h（T2）及术后7 d（T3）抽取外周静脉血，测定两组各时间段T淋巴细胞亚群（CD3⁺、CD4⁺、CD8⁺、CD4⁺/CD8⁺值）及NK细胞（CD16⁺56⁺）水平，分析两组麻醉手术后各时间点、各指标与T0时相比的变化。结果两组患者T1时与T0时比较，T淋巴细胞（CD3⁺、CD4⁺、CD4⁺/CD8⁺）及NK细胞（CD16⁺56⁺）水平均有所降低，其中A组降低水平有统计学意义（P < 0.05）；两组患者T2时与T0时比较T淋巴细胞（CD3⁺、CD4⁺、CD4⁺/CD8⁺）及NK细胞（CD16⁺56⁺）水平均明显降低，差异均有统计学意义（A组P < 0.01，B组P < 0.05），组间比较A组下降程度较B组更显著（P < 0.05）；两组患者T3时各指标均接近T0水平（P>0.05）；各时间点两组患者CD8⁺变化均无统计学意义（P>0.05）。结论全凭静脉麻醉与静脉全麻复合腰硬联合麻醉对腹腔镜前列腺癌根治术患者均有一过性不同程度的细胞免疫功能抑制，而静脉全麻复合腰硬联合麻醉的抑制作用较轻。
- 全凭静脉麻醉 /
- 腰硬联合麻醉 /
- 前列腺癌 /
- 细胞免疫功能
Abstract: ObjectiveTo discuss the effects of different anesthesia on the cellular immune function of perioperative period in patients with laparoscopic radical prostatectomy.Methods18 patients with laparoscopic radical prostatectomy were randomly divided into two groups: total intravenous anesthesia group (groupA) and general anesthesia reunite with combined spinal-epidural anesthesia group (groupB), 9 cases in each group.Venous blood were sampled respectively in 1h before anesthesia (T0), 1h (T1), 24 h (T2) and 7 d (T3) after anesthesia, then determined between the two groups at each time period of T lymphocyte subsets (CD3⁺, CD4⁺, CD8⁺, CD4⁺/CD8⁺ratio) and NK cell (CD16⁺56⁺) levels, and then analysis the changes of the indexs between different time points after operation and T0 in two groups.ResultsTwo groups of patients were decreased in the levels of T cell subsets (CD3 ⁺, CD4 ⁺, CD4 ⁺/CD8 ⁺ratio) and NK cells (CD16 ⁺56 ⁺) at T1 compared with T0, and the levels of group A decreased significantly (P < 0.05). Two groups of the levels of T cell subsets (CD3⁺, CD4⁺, CD4⁺/CD8⁺ratio) and NK cells (CD16 ⁺56 ⁺) decreased lower at T2 than T0 (groupA:P < 0.01, groupB:P < 0.05), and group A decreased lower than group B (P < 0.05). All the datas of the two groups were closed to the levels of T0 at T3 (P>0.05). The levels of CD8+ changed unsignificantly at all time points in two groups (P>0.05).ConclusionsBoth total intravenous anesthesia and general anesthesia reunite with combined spinal-epidural anesthesia have different degrees of temporary inhibition of cellular immune function for patients with laparoscopic radical prostatectomy, the latter is a lesser inhibitory effect.
- total intravenous anesthesia /
- combined spinal-epidural anesthesia /
- prostate cancer /
- cellular immune function

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表 1 两组患者各时间点T淋巴细胞亚群、NK细胞水平的比较（n=9）

时间点	组別	丁淋巴细胞亚群(%)				NK细胞(%)
时间点	组別	CD₃⁺	CD₄⁺	CD₈⁺	CD₄⁺/CD₈⁺	CD₁₆₊₅₆⁺
T₀	A	57.62±7.56	33.27±10.17	27.35±5.26	2.11±0.78	10.89±5.32
T₀	B	56.84±8.45	32.83±10.43	27.38±6.02	2.09±0.65	10.87±5.29
T₁	A	46.22±7.32^a	26.33±9.87^a	27.19±5.95	1.82±0.69^a	8.52±6.01^a
T₁	B	49.31±7.93	28.16±10.19	27.25±5.98	1.94±0.71	9.13±5.87
T₂	A	40.22±7.56^ab	21.53±10.10^ab	27.20±5.77	1.58±0.60^ab	7.26±5.65^ab
T₂	B	45.16±7.87^ac	24.31±10.12%	27.25±5.86	1.72±0.68%	8.66±5.97%
T₃	A	55.34±7.61	31.67±10.20	27.31±5.89	1.98±0.73	10.63±5.12
T₃	B	56.41±7.90	32.20±10.33	27.33±6.11	2.06±0.71	10.72±5.33
与T₀比较，^aP < 0.05，^bP < 0.01；两组间比较，^cP < 0.05.

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参考文献(9)

[1]	李萍.麻醉与免疫研究进展[J].齐齐哈尔医学院学报, 2010, 31(14): 2296-7. http://www.cnki.com.cn/Article/CJFDTOTAL-QQHB201014077.htm
[2]	刘勇.前列腺癌的免疫治疗进展[J].西南国防医药, 2013, 23(11): 1256-8. http://www.cnki.com.cn/Article/CJFDTOTAL-XNGF201311057.htm
[3]	Wu Y, Wan T, Zhou X, et al. Hsp70-like protein 1 fusion protein enhances induction of carcinoembryonic antigen-specific CD8+ CTL response by dendritic cell vaccine[J]. Cancer Res, 2005, 65(11): 4947-54. doi: 10.1158/0008-5472.CAN-04-3912
[4]	Ikeda H, Chamoto K, Tsuji T, et al. The critical role of type-1 innate and acquired immunity in tumor immunotherapy[J]. Cancer Sci, 2004, 95(9): 697-703. doi: 10.1111/cas.2004.95.issue-9
[5]	王世端, 王士雷, 江岩, 等.等容血液稀释自体输血对肿瘤病人围术期T淋巴细胞亚群、NK细胞影响的比较[J].中华麻醉学杂志, 2001(9): 12-4. http://www.cnki.com.cn/Article/CJFDTOTAL-ZHMZ200109003.htm
[6]	黄泽清, 高浩然, 俞伟平.丙泊酚靶控输注清醒镇静对患者围术期T细胞亚群及NK细胞的影响[J].临床麻醉学杂志, 2012, 28(5): 427-9. http://www.cnki.com.cn/Article/CJFDTOTAL-LCMZ201205005.htm
[7]	古炽明, 潘明沃, 陈志强, 等.前列腺癌患者T淋巴细胞亚群及NK细胞的变化[J].南方医科大学学报, 2009, 29(10): 2140-1. http://www.cnki.com.cn/Article/CJFDTOTAL-DYJD200910058.htm
[8]	李军, 李冠雄, 李静.不同麻醉方法对胃癌根治术患者围术期免疫功能的影响[J].实用医技杂志, 2008, 15(15): 1988-9. http://www.cnki.com.cn/Article/CJFDTOTAL-SYYJ200815064.htm
[9]	邢翠燕, 吴明毅, 范海鹏.不同麻醉和镇痛方法对食管癌手术患者细胞免疫功能及应激激素水平的影响[J].南方医科大学学报, 2010, 30 (2): 284-7. http://www.cnki.com.cn/Article/CJFDTOTAL-DYJD201002025.htm

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不同麻醉方式对腹腔镜前列腺癌根治术患者围术期细胞免疫功能的影响

doi: 10.3969/j.issn.1674-4500.2015.02.06

作者简介:
金楠，在职硕士在读，主治医师，E-mail: gzjinnan@yeah.net

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Application of three dimensional visualization technology for laparoscopic Resection of cystic carcinoma in pancreatic body and tail

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不同麻醉方式对腹腔镜前列腺癌根治术患者围术期细胞免疫功能的影响

doi: 10.3969/j.issn.1674-4500.2015.02.06

作者简介: 金楠，在职硕士在读，主治医师，E-mail: gzjinnan@yeah.net

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Application of three dimensional visualization technology for laparoscopic Resection of cystic carcinoma in pancreatic body and tail

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出版历程

目录

作者简介:
金楠，在职硕士在读，主治医师，E-mail: gzjinnan@yeah.net