CAJ | 학술논문

目的：评价艾司洛尔对腹腔镜直肠癌根治术患者免疫功能及炎性反应的影响。方法择期在全麻下行腹腔镜直肠癌根治术患者40例，性别不限，年龄40-70岁，ASA分级Ⅰ-Ⅱ级，采用随机数字表法，将患者随机分为2组(n=20)：艾司洛尔组（E组）和生理盐水对照组（C组）。 E组于气管插管即刻静脉注射艾司洛尔0.3mg/kg，随后以30μg/（kg·min）速度输注60min，C组以同样方法静脉输注等容量生理盐水。分别于麻醉诱导前（T0）、手术开始后2h（T1）及术后2h时采集静脉血样（T2），采用ELISA法测定患者血清IFN-γ、IL-4、IL-6浓度，并于术后1d（T4）时测定C反应蛋白（CRP）水平及白细胞（WBC）计数，记录WBC升高的患者例数。结果与T0时比较，T1-T2时C组患者IFN-γ浓度及IFN-γ/IL-4降低，IL-4及IL-6浓度升高，T2时E组患者IFN-γ浓度及IFN-γ/IL-4降低，IL-4及IL-6浓度升高(P<0.05)，T1时差异无统计学意义(P>0.05)。与C组比较，E组患者T1-T2时IFN-γ浓度及IFN-γ/IL-4升高，IL-4及IL-6浓度降低，T4时CRP 水平降低(P<0.05)，WBC计数及WBC升高患者例数差异无统计学意义(P>0.05)。结论艾司洛尔可改善腹腔镜直肠癌根治术患者围术期免疫功能，减轻患者术后炎性反应。
목적：평개애사락이대복강경직장암근치술환자면역공능급염성반응적영향。방법택기재전마하행복강경직장암근치술환자40례，성별불한，년령40-70세，ASA분급Ⅰ-Ⅱ급，채용수궤수자표법，장환자수궤분위2조(n=20)：애사락이조（E조）화생리염수대조조（C조）。 E조우기관삽관즉각정맥주사애사락이0.3mg/kg，수후이30μg/（kg·min）속도수주60min，C조이동양방법정맥수주등용량생리염수。분별우마취유도전（T0）、수술개시후2h（T1）급술후2h시채집정맥혈양（T2），채용ELISA법측정환자혈청IFN-γ、IL-4、IL-6농도，병우술후1d（T4）시측정C반응단백（CRP）수평급백세포（WBC）계수，기록WBC승고적환자례수。결과여T0시비교，T1-T2시C조환자IFN-γ농도급IFN-γ/IL-4강저，IL-4급IL-6농도승고，T2시E조환자IFN-γ농도급IFN-γ/IL-4강저，IL-4급IL-6농도승고(P<0.05)，T1시차이무통계학의의(P>0.05)。여C조비교，E조환자T1-T2시IFN-γ농도급IFN-γ/IL-4승고，IL-4급IL-6농도강저，T4시CRP 수평강저(P<0.05)，WBC계수급WBC승고환자례수차이무통계학의의(P>0.05)。결론애사락이가개선복강경직장암근치술환자위술기면역공능，감경환자술후염성반응。
Objective To evaluate the effect of esmolol on immune function and inflammatory response in patients undergoing laparoscopic radical resection of rectal carcinoma. Methods 40 patients undergoing laparoscopic radical resection of rectal carci-noma were enrolled,all genders,age 40-70,ASAⅠ-Ⅱ,using random number table,patients were randomly divided into two groups (n=20):esmolol group (E group) and saline control group (group C). Immediately after induction of anaesthesia ,the patients in the esmolol group (n=20) were infused with a 0.3mg·kg-1 loading dose of esmolol followed by an infusion of 30μg·kg-1·min-1, whereas the patients in the saline group(n=20) were infused with 0.9%saline solution of the same volume. Peripheral venous blood samples were collected before induction of anesthesia (T0),at 2h after surgery began(T1) and at 2h after surgery(T2). The concentra-tions of IFN-γ,IL-4 and IL-6 were measured by ELISA,and determinate of CRP levels and WBC count,record the number of patients with WBC raised in the postoperative 1d (T4). Results Compared with T0,group C was associated with IFN-γand IFN-γ/IL-4 lower,IL-4 and IL-6 raised at T1,T2 (P<0.05);group E patients was associated with IFN-γand IFN-γ/IL-4 lower,IL-4 and IL-6 raised at T2 (P<0.05),but there was no significant difference at T1 (P>0.05). Compared with group C,group E was associated with IFN-γand IFN-γ/IL-4 raised,IL-4 and IL-6 lower,CRP levels was decreased at T4(P<0.05),WBC count and number of pa-tients with WBC increased showed no significant difference (P>0.05). Conclusion Esmolol played an immunomodulatory role and mitigated the postoperative inflammatory response in patients undergoing laparoscopic radical resection of rectal carcinoma.