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 h（T2）、术后第 3 天（T3）及术后第 7 天（T4）采集外周血，检测 CD4+ T、CD8+ T、CD28+ CD8+ T、PD⁃1+ CD8+ T、CD45RO+ CD62L⁃CD8+ T 及 CD45RO+ CD62L+ CD8+ T。结果 Sev 组和 Pro 组 CD4+ T/CD8+ T 在 T2时都低于 T1，Sev 组 CD4+ 、CD4+ T/CD8+ T 在 T2、和 T3时低于 Pro 组，PD⁃1+ CD8+ T 在 T2时 高于 Pro 组，CD28+ CD8+ T 在 T2时低于 Pro 组（P < 0.05）；Sev 组 CD45RO+ CD62L⁃CD8+ T、CD45RO+ CD62L+ CD8+ T 在T3、T4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。

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 group（n = 32） and Pro group（n = 32）. The Sev group was treated with inhalation of sevoflurane，and the Pro group received intra⁃ venous infusion of propofol. Peripheral blood samples were collected before anesthesia（T1），2 hours after anesthesia （T2），3 days after operation（T3）and 7 days after operation（T4）. CD4+ T，CD8+ T，CD28+ CD8+ T，PD⁃1+ CD8+ T， CD45RO+ 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+ T，CD4+ T/CD8+ T in the Sev group were lower than thatin the Pro Group at T2 and T3，PD⁃1+ CD8+ T was higher than that in the Pro Group at T2，and CD28+ CD8+ T was lower than that in the Pro Group at T2（P < 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 T4（P < 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 cells，as compared to inhalation anesthesia of sevoflurane.