帕瑞昔布钠超前镇痛对肿瘤术后淋巴细胞亚群的影响

目的研究帕瑞昔布钠超前镇痛对肿瘤术后淋巴细胞亚群的影响。方法择期肿瘤外科手术患者40例,随机均分为2组:Ⅰ组麻醉诱导前30 min静脉给予帕瑞昔布钠40 mg(稀释为2 mL);Ⅱ组给予生理盐水2 mL。分别于麻醉诱导前(T0)、术毕(T1)、术后24 h(T2)、术后48 h(T3)抽取外周静脉血2 mL,测定T细胞分化抗原(CD3+)、辅助性T细胞(CD4+)、抑制性T细胞(CD8+)的表达及NK细胞水平。结果两组患者的术后镇痛效果良好。与麻醉前比较,术毕2组CD3+、CD4+、CD4+/CD8+及NK细胞水平均明显下降(P<0.05)。术后24 h,Ⅰ组CD3+、CD4+及NK明显高于Ⅱ组;术后48 h,Ⅰ组CD4+/CD8+明显高于Ⅱ组(P<0.05)。结论两组患者的细胞免疫功能在术后短期均受到不同程度的抑制,但帕瑞昔布钠超前镇痛对细胞免疫功能有一定的保护作用。

Effect of preemptive parecoxib sodium for postoperative analgesia on T-cell subtypes of patients undergoing alimentary tract tumor surgery

Objective To observe the efficacy of parecoxib sodium preemptive analgesia on T-cell subtypes in patients undergoing alimentary tract tumor surgery.Methods Forty patients(ASA Ⅰor Ⅱ)were randomly allocated to 2 groups,and they received preemptive parecoxib sodium plus morphine or morphine alone,20 cases in each group.Blood samples were taken before surgery(T0),end of surgery(T1),24 h after surgery(T2),48 h after surgery(T3)for the determination of CD3+,CD4+,CD8+ and NK cells using flowcytometry.Results The effective rate of analgesia is good.Compared with T0,CD3+,CD4+,CD4+/CD8+ and NK significantly decreased at T1 in both groups(P<0.05).The CD3+,CD4+ and NK of group Ⅰ were higher than those of group Ⅱ at T2(P<0.05),At 48 h after operation,CD4+/CD8+ in group Ⅰ was higher than that of group Ⅱ(P<0.05).Conclusion Both groups have certain inhibitive effects on immune system,parecoxib sodium preemptive analgesia can attenuate the immunosuppressive effect of morphine.