曲马多和吗啡预先给药对小儿静脉血T淋巴细胞增殖及IL-2水平的影响

目的 观察曲马多和吗啡预先给药对小儿静脉血T淋巴细胞增殖及IL-2水平的影响。方法 采集无免疫性疾病的60例门诊小手术患儿外周静脉血5mL,进行全血和外周血单个核细胞（PBMCs）培养。随机分为空白对照组（C组）、吗啡（100ng·mL^-1）组（M组）及曲马多（500ng．mL^-1）组（T组）,每组20例。培养的PBMCs和全血在体外均用相应药物预先作用48h,用刺激剂刺激后测定T淋巴细胞增殖状态及血清白细胞介素2（IL-2）分泌水平。结果 与C组比较,M组cpm值明显降低（P〈0．01）;T组cpm值增高（P〈0．05）。与C组比较,M组IL-2水平明显降低（P〈0．01）;T组IL-2水平增高（P〈0．0S）。结论 吗啡和曲马多对小儿免疫功能有不同的影响。选择曲马多作为小儿术后镇痛的药物更为合适,可以减少对免疫功能的抑制。

Effects of pretreatment with tramadol or morphine on children T lymphocyte proliferation and serum interleukin-2 in vitro

OBJECTIVE To investigate and compare the effects of pretreatment with tramadol and morphine on children T lymphocyte proliferation and serum interleukin-2 （IL-2） in vitro. METHODS Sixty ASA Ⅰ patients aged 3-7yrs scheduled for minor day-care surgery were enrolled in this study. Blood samples were taken from peripheral vein. The mononuclear cells isolated from peripheral blood （PBMCs） and whole blood were incubated with medium （group C, n = 20）, morphine 100ng·mL^-1 （group M, n = 20） or tramadol 500ng·mL^-1 （group T, n = 20） for 48h. Then irritants was added and incubated for another 6 or 24h. Lymphocyte proliferation was evaluated by mixed lymphocyte culturing. In the whole blood the level of IL-2 were determined by enzyme linked immunosorbent assay （ELASA）. RESULTS The cpm value of group M was significantly lower than that of group C（P〈0.01）.But the cpm value of group T was higher than that of group C（P〈0.05）. The serum IL-2 level decreased significantly in group M, but increased in group T compared with group C （P 〈 0.01, P 〈（0.05）. CONCLUSION Tramadol and morphine have different effect on immune function of children. Tramadol can enhance immune function, and it is more suitable for children postoperation analgesia.