实用医学杂志 ›› 2022, Vol. 38 ›› Issue (20): 2549-2555.doi: 10.3969/j.issn.1006⁃5725.2022.20.008

• 临床研究 • 上一篇    下一篇

吸入与静脉全身麻醉对结直肠肿瘤患者围术期 T细胞分型的影响

李富裕 冯建国 王晓斌 白毅平    

  1. 西南医科大学附属医院(四川泸州646000

  • 出版日期:2022-10-25 发布日期:2022-10-25
  • 通讯作者: 白毅平 E⁃mail:baiyiping0608@163.com
  • 基金资助:
    四川省卫生健康委员会医学科技项目(编号:21PJ094)

Impact of intravenous anesthesia vs. inhalation anesthesia on perioperative T cells subsets in patients with colorectal cancer

 LI FuyuFENG JianguoWANG XiaobinBAI Yiping.   

  1. Department of AnesthesiologyAffiliated Hospital of Southwest Medical UniversityLuzhou 646000China 

  • Online:2022-10-25 Published:2022-10-25
  • Contact: BAI Yiping E⁃mail:baiyiping0608@163.com
  • Supported by:


摘要:

目的 比较吸入和静脉全身麻醉对结直肠癌患者 T 细胞亚群及 CD8+ T 细胞表面信号分子的影响。方法 64例结直肠癌根治术患者随机分为Sev 组(n = 32)和Pro 组(n = 32)。Sev 组吸入七氟醚,Pro 组静脉泵入异丙酚。麻醉诱导前(T1)、麻醉 2 hT2)、术后第 3 天(T3)及术后第 7 天(T4)采集外周血,检测 CD4+ TCD8+ TCD28+ CD8+ TPD⁃1+ CD8+ TCD45RO+ CD62L⁃CD8+ T CD45RO+ CD62L+ CD8+ T结果 Sev 组和 Pro CD4+ T/CD8+ T T2时都低于 T1Sev CD4+ CD4+ T/CD8+ T T2、和 T3时低于 Pro 组,PD⁃1+ CD8+ T T2时 高于 Pro 组,CD28+ CD8+ T T2时低于 Pro 组(P < 0.05);Sev CD45RO+ CD62L⁃CD8+ TCD45RO+ CD62L+ CD8+ T T3T4时低于Pro 组(P < 0.05)。结论 全身麻醉可引起结直肠癌患者免疫抑制,但异丙酚静脉麻醉抑制 更轻;异丙酚静脉麻醉对记忆T细胞抑制比七氟醚吸入麻醉轻。

关键词:

全身麻醉, 结直肠癌, T细胞, CD4, CD8

Abstract:

Objective To compare the impact of intravenous anesthesia versus inhalation anesthesia on T cell subsets and CD8+ T cell surface signaling molecules in patients with colorectal cancer. Methods Sixty⁃four patients with colorectal cancer undergoing elective radical resection were randomly divided into Sev groupn = 32and Pro groupn = 32. The Sev group was treated with inhalation of sevofluraneand the Pro group received intra⁃ venous infusion of propofol. Peripheral blood samples were collected before anesthesiaT1),2 hours after anesthesia T2),3 days after operationT3and 7 days after operationT4. CD4+ TCD8+ TCD28+ CD8+ TPD⁃1+ CD8+ TCD45RO+ CD62LCD8+ T and CD45RO+ CD62L+ CD8+ T were detected and analyzed. Results CD4+ T/CD8+ T at T2 was lower than that at T1 in both groups. CD4+ TCD4+ T/CD8+ T in the Sev group were lower than thatin the Pro Group at T2 and T3PD⁃1+ CD8+ T was higher than that in the Pro Group at T2and CD28+ CD8+ T was lower than that in the Pro Group at T2P < 0.05. CD45RO+ CD62LCD8+ T and CD45RO+ CD62L+ CD8+ T in the Sev group were lower than those in the Pro group at T3 and T4P < 0.05. Conclusion General anesthesia may cause immunosuppression in colorectal cancer patients and the intravenous anesthesia of propofol causes less immunosuppression. Moreover intravenous anesthesia of propofolhas less inhibitory effect on memory T cellsas compared to inhalation anesthesia of sevoflurane. 

Key words: general anesthesia,  , colorectal cancer,  , T cell,  , CD4,  , CD8