南昌大学学报（医学版）
南昌大學學報（醫學版）
남창대학학보（의학판）
ACTA ACADEMIAE MEDICINAE JIANGXI
2014年
6期
38-40,43
,共4页
右美托咪定%乳腺肿瘤%T淋巴细胞亚群%NK细胞%免疫功能
右美託咪定%乳腺腫瘤%T淋巴細胞亞群%NK細胞%免疫功能
우미탁미정%유선종류%T림파세포아군%NK세포%면역공능
dexmedetomidine%breast neoplasm%T lymphocyte subsets%natural killer cells%immune function
目的：探讨右美托咪定对乳腺癌根治术患者T淋巴细胞亚群及 NK细胞的影响。方法选择 ASAⅠ或Ⅱ级择期全身麻醉下行乳腺癌根治术患者60例，随机分为右美托咪定组（D组）和对照组（C组），每组30例。D组于麻醉诱导前15 min经静脉输注右美托咪定1．0μg·kg-1，继而以0．5μg·kg-1·h-1的速率维持至术毕，C组给予等容量生理盐水。分别于麻醉诱导前（T0）、手术开始后2 h，术后6、24 h及3、7 d（T1-T5）6个时点采集静脉血样，采用流式细胞仪检测T淋巴细胞亚群（CD＋3、CD＋4、CD＋8）及 NK细胞浓度，并计算 CD＋4/CD＋8比值。结果与C组比较，D组T1-T3时CD＋3、CD＋4、NK细胞浓度及CD＋4/CD＋8比值升高（P＜0．05），CD＋8水平各时点比较差异无统计学意义（P＞0．05）；与 T0时比较，T1-T4时2组患者 CD＋3、CD＋4、NK 细胞浓度及 CD＋4/CD＋8比值降低（P＜0．05），T5时差异无统计学意义（P＞0．05）。结论右美托咪定对乳腺癌根治术患者 T淋巴细胞亚群和 NK细胞具有保护作用，可减轻围术期细胞免疫功能抑制。
目的：探討右美託咪定對乳腺癌根治術患者T淋巴細胞亞群及 NK細胞的影響。方法選擇 ASAⅠ或Ⅱ級擇期全身痳醉下行乳腺癌根治術患者60例，隨機分為右美託咪定組（D組）和對照組（C組），每組30例。D組于痳醉誘導前15 min經靜脈輸註右美託咪定1．0μg·kg-1，繼而以0．5μg·kg-1·h-1的速率維持至術畢，C組給予等容量生理鹽水。分彆于痳醉誘導前（T0）、手術開始後2 h，術後6、24 h及3、7 d（T1-T5）6箇時點採集靜脈血樣，採用流式細胞儀檢測T淋巴細胞亞群（CD＋3、CD＋4、CD＋8）及 NK細胞濃度，併計算 CD＋4/CD＋8比值。結果與C組比較，D組T1-T3時CD＋3、CD＋4、NK細胞濃度及CD＋4/CD＋8比值升高（P＜0．05），CD＋8水平各時點比較差異無統計學意義（P＞0．05）；與 T0時比較，T1-T4時2組患者 CD＋3、CD＋4、NK 細胞濃度及 CD＋4/CD＋8比值降低（P＜0．05），T5時差異無統計學意義（P＞0．05）。結論右美託咪定對乳腺癌根治術患者 T淋巴細胞亞群和 NK細胞具有保護作用，可減輕圍術期細胞免疫功能抑製。
목적：탐토우미탁미정대유선암근치술환자T림파세포아군급 NK세포적영향。방법선택 ASAⅠ혹Ⅱ급택기전신마취하행유선암근치술환자60례，수궤분위우미탁미정조（D조）화대조조（C조），매조30례。D조우마취유도전15 min경정맥수주우미탁미정1．0μg·kg-1，계이이0．5μg·kg-1·h-1적속솔유지지술필，C조급여등용량생리염수。분별우마취유도전（T0）、수술개시후2 h，술후6、24 h급3、7 d（T1-T5）6개시점채집정맥혈양，채용류식세포의검측T림파세포아군（CD＋3、CD＋4、CD＋8）급 NK세포농도，병계산 CD＋4/CD＋8비치。결과여C조비교，D조T1-T3시CD＋3、CD＋4、NK세포농도급CD＋4/CD＋8비치승고（P＜0．05），CD＋8수평각시점비교차이무통계학의의（P＞0．05）；여 T0시비교，T1-T4시2조환자 CD＋3、CD＋4、NK 세포농도급 CD＋4/CD＋8비치강저（P＜0．05），T5시차이무통계학의의（P＞0．05）。결론우미탁미정대유선암근치술환자 T림파세포아군화 NK세포구유보호작용，가감경위술기세포면역공능억제。
Objective To investigate the effects of dexmedetomidine on T lymphocyte subsets and natural killer(NK)cells in patients undergoing radical excision for breast cancer.Methods Sixty ASA Ⅰor Ⅱ patients scheduled for elective modified radical mastectomy under general an-esthesia were randomly divided into two groups,with 30 patients in each group.Patients in dexmedetomidine group(group D)were given intravenous infusion of dexmedetomidine at 1μg· kg-1 1 5 minutes before anesthesia induction,followed by intravenous infusion of dexmedetomidine at 0.5μg·kg-1/hour until the end of surgery.Patients in control group(group C)were given the same volume of normal saline.Venous blood samples were collected before anesthesia induction of (T0 ),2 hours after the beginning of operation(T1 ),6 hours after operation(T2 ),24 hours after operation(T3 ),3 days after operation(T4 )and 7 days after operation(T5 ).T-lymphocyte subsets (CD+3 ,CD+4 and CD+8 )and NK cells were measured by flow cytometry and CD+4/CD+8 ratio was calculated.Results Compared with group C,levels of CD+3 ,CD+4 and NK cells and ratio of CD+4/CD+8 significantly increased in group D at T1-T3 (P<0.05).There were no significant differences in levels of CD+8 cells among different time points(P>0.05).Compared with T0 ,levels of CD+3 ,CD+4 and NK cells and ratio of CD+4/CD+8 significantly decreased at T1-T4 in both groups (P<0.05).No significant differences in these parameters were found between T0 and T5 (P>0.05). Conclusion Dexmedetomidine exerts a protective effect on T lymphocyte subsets and NK cells and alleviates perioperative immunosuppression in patients undergoing radical excision for breast cancer.
