CAJ | 학술논문

目的：研究帕瑞昔布钠超前镇痛对大肠癌切除术患者的炎性因子C-反应蛋白及细胞免疫功能影响。方法择期行大肠癌切除术的患者40例，年龄41~67岁，体质量53~82 kg，ASA分级Ⅰ或Ⅱ级。采用随机数字表法，将患者随机分为二组（n=20）：P组麻醉诱导前30 min静脉给予帕瑞昔布钠40 mg（稀释为5 mL），N组给予生理盐水5 mL。测定二组患者麻醉诱导前30 min（T0）、切皮后2 h（T1）、术毕（T2）和术后24h（T3）时，采外周静脉血样，测定血浆CRP及T淋巴亚群CD3+、CD4+、CD8+和自然杀伤细胞的水平，计算CD4+/CD8+。结果与T0比较，P组及N组T2时CRP水平升高（P＜0.05）；P组T2、T3时IL-6降低（P＜0.05）；N组T2时CD3+、CD4+、CD4+/CD8+、NK cell降低（P＜0.05）。与N组比较，P组T2、T3时CRP水平升高（P＜0.05），T2时CD3+、CD4+、CD4+/CD8+、NK cell升高（P＜0.05）。结论帕瑞昔布钠超前镇痛对腹腔镜大肠癌切除术患者CRP的释放起降低作用，对其细胞免疫功能影响小，是值得临床推荐的方法。
목적：연구파서석포납초전진통대대장암절제술환자적염성인자C-반응단백급세포면역공능영향。방법택기행대장암절제술적환자40례，년령41~67세，체질량53~82 kg，ASA분급Ⅰ혹Ⅱ급。채용수궤수자표법，장환자수궤분위이조（n=20）：P조마취유도전30 min정맥급여파서석포납40 mg（희석위5 mL），N조급여생리염수5 mL。측정이조환자마취유도전30 min（T0）、절피후2 h（T1）、술필（T2）화술후24h（T3）시，채외주정맥혈양，측정혈장CRP급T림파아군CD3+、CD4+、CD8+화자연살상세포적수평，계산CD4+/CD8+。결과여T0비교，P조급N조T2시CRP수평승고（P＜0.05）；P조T2、T3시IL-6강저（P＜0.05）；N조T2시CD3+、CD4+、CD4+/CD8+、NK cell강저（P＜0.05）。여N조비교，P조T2、T3시CRP수평승고（P＜0.05），T2시CD3+、CD4+、CD4+/CD8+、NK cell승고（P＜0.05）。결론파서석포납초전진통대복강경대장암절제술환자CRP적석방기강저작용，대기세포면역공능영향소，시치득림상추천적방법。
Objective To investigate the effects of parecoxib on plasma C-reactive protein (CRP) and cellular immune function in patients undergoing laparoscopic surgery for colorectal cancer. Methods 40 patients undergoing laparoscopic surgery for colorectal cancer were randomly divided into two groups of parecoxib(group P) , and NS(group N) with cases each. The cervical venous blood samples were obtained from the patients at 30 min before anesthesia indution (T0), at 2h of operation(T1), immediately (T2)and 24 h postoperation(T3) for determination of the expression of CRP, CD3+,CD4+,CD8+on T cells and natural killer cell. Results Cornpared with T0, plasma CRP of group P and group N was markedly increased at T2 (P<0.05) . The expression of CD3+,CD4+, CD4+/CD8+,NK cell in group N was markedly decreased at T2. Cornpared with group N, plasma CRP, the expression of CD3+,CD4+, CD4+/CD8+,NK cell in group P was increased. Conclusion Parecoxib can suppress the generation and release of inflammatory cytokine CRP and have no influence on cellular immune function in patients undergoing laparoscopic surgery for colorectal cancer.