不同麻醉方式对炎性细胞因子的影响

目的比较雷米芬太尼-丙泊酚全凭静脉麻醉与异氟醚静吸复合全身麻醉用于胆囊切除术对促炎性和抗炎性细胞因子的影响。方法慢性胆囊炎或胆囊结石患者28例,ASAⅠ或Ⅱ级,随机均分为全凭静脉麻醉组(T组)和静吸复合麻醉组(I组),测定两组患者麻醉前、术后4、12h血浆细胞因子白细胞介素-6(IL-6)和白细胞介素-10(IL-10)水平。结果两组血浆IL-6、IL-10水平在术后4h均显著升高(P<0.05)。术后12hT组血浆IL-6水平显著低于I组(P<0.05)。结论雷米芬太尼-丙泊酚全凭静脉麻醉可增强抗炎细胞因子反应,有利于减轻手术应激的炎症反应。

Effect of total intravenous anesthesia on inflammatory cytokines

Objective To compare the effects of different anaesthetic techniques on the pro-and anti-inflammatory cytokines.Methods Twenty-eight patients undergoing cholecystectomy were randomly assigned to two groups with 14 cases each.Total intravenous anesthesia(TIVA)with propofol and remifentanil was used in group T and isoflurane inhalational anaesthesia combined with fantanyl in group I.Blood samples were collected before induction of anaesthesia,at 4,12 h after skin incision.IL-6 and IL-10 were measured using enzyme-linked immunosorbent assay(ELISA).Results The plasma levels of IL-6 and IL-10 were significantly increased at 4 h after skin incision compared with those before in both groups(P<0.05).The level of IL-6 at 12 h after skin incision was significantly lower in group T than that in group I(P<0.05).Conclusion TIVA with propofol and remifentanil can suppress the inflammatory response to surgery by promoting the increase of anti-inflammatory cytokines.