不同麻醉方法对胃肠道肿瘤手术病人细胞免疫功能的影响

目的:探讨不同麻醉方法对胃肠道肿瘤患者围术期外周血T细胞亚群以及白细胞介素-2(IL-2)的影响.方法:选择胃肠道肿瘤手术患者40例,随机分为两组.采用单纯全麻者为对照组,采用全麻复合硬膜外麻醉者为治疗组.分别于麻醉前、麻醉后不同时间点抽取静脉血,流式细胞术测定CD4+T及CD8+T细胞亚群数量,ELISA法测定血清IL-2的浓度.结果:麻醉后两组患者的CD4+T细胞、CD4+/CD8+比值和血清IL-2浓度均有所下降,与麻醉前比较差异有统计学意义(P＜0.05),治疗组患者的CD4+T细胞及IL-2下降程度不如对照组患者明显,且恢复较快,两组间差异有统计学意义(P＜0.05).结论:胃肠道肿瘤患者在麻醉手术后其细胞免疫功能受到不同程度的抑制,但复合麻醉较单纯全麻的免疫抑制效应低且恢复较快.

The Impact of Different Anaesthesia Methods on the Cellular Immune Function of Patients with Gastrointestinal Tumor Surgery

Objective: To explore the impact of different ways of anesthesia on T cell subsets and leukocyte interleukin-2(IL-2) in perioperative peripheral blood of gastrointestinal tumor patients.Methods: 40 surgery patients who selected to have gastrointestinal tumor surgery were randomly divided into two groups,Conterol group using general anesthesia,and Treat group using anesthesia combined w-ith epidural anesthesia.Extracted venous blood at different time points before or after anesthesia.Flow cytometry was applied to detect the amount of CD4+T and CD8+T cell subsets in peripheral blood,and ELISA was adopted to detect the concentration of serum IL-2.Results: The CD4+T cell subsets in peripheral blood,CD4+ /CD8+ ratio and serum IL-2 concentration were decreased after anesthesia in two groups,difference with statistical significance as compared with that of before anesthesia(P<0.05).The levels of CD4+T and IL-2 in patients of Treat Group decreased less than patients of Control Group and restored more quickly(P<0.05).Conclusion: The cell immune function of gastrointestinal tumor patients was inhibited to different degrees during anesthesia.Combined anesthesia made less immunosuppressive effects and faster recovery than general anesthesia.