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丙泊酚与七氟醚麻醉对围手术期患者外周血辅助性T淋巴细胞分化的对比研究

Comparsion of propofol anesthesia and sevoflurance anesthesia on differentiation of peripheral helper T lymphocytes in perioperative patients

  • 摘要: 目的: 探讨丙泊酚与七氟醚麻醉下辅助性T淋巴细胞(helper T lymphocytes,Th)分化的差异性。方法: 选择2010年10月—2015年1月择期行腰椎间盘突出症手术患者60例,随机分为丙泊酚全凭静脉麻醉组(丙泊酚麻醉组)和七氟醚吸入麻醉组(七氟醚麻醉组),各30例。所有患者行无创血压、心率、脉搏血氧饱和度、呼气末二氧化碳分压监测。于麻醉前、麻醉后、手术开始前、手术开始后、术后1 d采集外周静脉血,检测各组患者T细胞对γ-干扰素、白细胞介素4的表达,测定外周静脉血中Th1细胞与Th2细胞的百分率,及Th1细胞与Th2细胞的比值。结果: 2组患者无创血压、心率、脉搏血氧饱和度、呼气末二氧化碳分压差异均无统计学意义。丙泊酚麻醉组患者术后1 d外周静脉血Th1细胞百分率明显高于七氟醚麻醉组,差异有统计学意义(P< 0.05);2组患者不同时间点外周静脉血Th2细胞百分率差异均无统计学意义;丙泊酚麻醉组患者术后1 d外周静脉血Th1细胞与Th2细胞比值高于七氟醚麻醉组,差异有统计学意义(P< 0.05)。结论: 与七氟醚相比,丙泊酚能够促进Th细胞向Th1细胞分化,对围手术期患者具有一定的免疫保护作用。

     

    Abstract: Objective: To study the difference regarding differentiation of helper T lymphocytes(Th) between propofol anesthesia and sevoflurance anesthesia. Methods: A total of 60 patients, who received selective lumbar disc herniation surgery during Oct. 2010 and Jan. 2015, were selected and divided into two groups randomly, the propofol group which received total intravenous anesthesia with propofol and the sevoflurance group which received inhalation anesthesia with sevoflurance, with 30 cases in each. The non-invasive blood pressure, heart rate, pulse oxygen saturation, and end-tidal carbon dioxide partial pressure were monitored in all patients.Peripheral venous blood was sampled before and after anesthesia, before and after surgery, and one-day after surgery, respectively.The T cell expression on interferon-γ and interleukin-4, the percentage of Th1 cell and Th2 cell in peripheral blood, and the ratio between Th1 cell and Th2 cell were evaluated in each group. Results: There was no significant difference between the two groups regarding the non-invasive blood pressure, heart rate, pulse oxygen saturation, and end-tidal carbon dioxide partial pressure. The percentage of Th1 cell in peripheral blood in propofol group was significantly higher than that in sevoflurance group one-day after surgery(P< 0.05).There was no significant difference regarding the percentage of Th2 cell in peripheral blood between the two groups at different time point. The ratio between Th1 cell and Th2 cell in peripheral blood in propofol group was significantly higher than that in sevoflurance group one-day after surgery (P< 0.05). Conclusions: Compared with sevoflurance, propofol can preferably promote Th cell to differentiate into Th1 cell.Propofol may therefore have immunoprotective effect for patients during perioperative period.

     

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