术前静脉输注6%羟乙基淀粉200/0.5溶液对患者术后免疫功能的影响

目的 探讨术前静脉输注6%羟乙基淀粉(HES)200/0.5溶液对患者术后免疫功能的影响.方法 择期胆囊切除术患者40例,年龄21～58岁,体重47～79 kg,性别不限,ASA分级Ⅰ或Ⅱ级,采用随机数字表法,将患者随机分为2组(n=20):6%HES 200/0.5组(H组)和复方醋酸钠组(A组).麻醉诱导前经15 min静脉输注6%HES 200/0.5溶液或复方醋酸钠溶液10 ml/kg.于术前、术后1 h、术后1和3 d时取静脉血样,测定血清IL-6、IL-8、TNF-α、IL-2和IL-10以及IgG、IgA和IgM的浓度.结果 与术前比较,两组患者术后血清IL-6、IL-8、TNF-α、IL-2和IL-10浓度均升高,A组术后血清IgA和IgG浓度降低(P＜0.05或0.01),IgM浓度差异无统计学意义,H组上述指标差异无统计学意义(P＞0.05);与A组比较,H组术后血清IL-6、IL-8和TNF-α浓度降低,IL-2、IL-10、IgA和IgG浓度升高(P＜0.05).结论 术前静脉输注6%HES 200/0.5溶液可改善患者术后的免疫功能.

Abstract：

Objective To investigate the effect of 6 % hydroxyethyl starch (HES) 200/0.5 infusion before operation on postoperative immne function in patients. Methods Forty ASA Ⅰ or Ⅱ patients of both sexes aged 21-58 yr weighing 47-79 kg were randomly divided into 2 groups ( n = 20 each): 6% HES 200/0.5 group (group H) and compound sodium acetate group (group A). 6% HES 200/0.5 10 ml/kg or compound sodium acetate solution was infused intravenously over 15 min before anesthesia induction. Anesthesia was induced with iv injection of propofol, fentanyl and vecuronium and maintained with target-controlled infusion of propofol and infusion of remifentanil. Venous blood samples were collected before operation and at 1 h, 1 day and 3 days after operation to detect the serum concentrations of IL-6, IL-8, TNF-α, IL-2, IL-10, IgG, IgA andIgM. Results Serum concentrations of IL-6, IL-8, TNF-α, II-2 and IL-10 were significantly higher after operation in the two groups, and serum concentrations of IgA and IgG were significantly lower after operation in group A than those before operation ( P ＜ 0.05 or 0.01 ). Serum concentrations of IL-6, IL-8 and TNF-α were significantly lower, while serum concentrations of IL-2, IL-10, IgA and IgG were significantly higher after operation in group H than in group A ( P ＜0.05). Conclusion Preoperative infusion with 6% HES 200/0.5 can improve the immune function after operation in patients.

Effect of 6% hydroxyethyl starch 200/0.5 infusion before operation on postoperative immune function

Objective To investigate the effect of 6 % hydroxyethyl starch (HES) 200/0.5 infusion before operation on postoperative immne function in patients. Methods Forty ASA Ⅰ or Ⅱ patients of both sexes aged 21-58 yr weighing 47-79 kg were randomly divided into 2 groups ( n = 20 each): 6% HES 200/0.5 group (group H) and compound sodium acetate group (group A). 6% HES 200/0.5 10 ml/kg or compound sodium acetate solution was infused intravenously over 15 min before anesthesia induction. Anesthesia was induced with iv injection of propofol, fentanyl and vecuronium and maintained with target-controlled infusion of propofol and infusion of remifentanil. Venous blood samples were collected before operation and at 1 h, 1 day and 3 days after operation to detect the serum concentrations of IL-6, IL-8, TNF-α, IL-2, IL-10, IgG, IgA andIgM. Results Serum concentrations of IL-6, IL-8, TNF-α, II-2 and IL-10 were significantly higher after operation in the two groups, and serum concentrations of IgA and IgG were significantly lower after operation in group A than those before operation ( P ＜ 0.05 or 0.01 ). Serum concentrations of IL-6, IL-8 and TNF-α were significantly lower, while serum concentrations of IL-2, IL-10, IgA and IgG were significantly higher after operation in group H than in group A ( P ＜0.05). Conclusion Preoperative infusion with 6% HES 200/0.5 can improve the immune function after operation in patients.