异丙酚和异氟烷对肺癌根治术患者围术期血浆细胞因子的影响

目的探讨异丙酚和异氟烷麻醉对肺叶切除术肺癌患者围术期血浆细胞因子的影响。方法选择择期行肺叶切除术肺癌患者38例,随机分为异丙酚组和异氟烷组,每组19例。两组均于麻醉前（T0）、麻醉后切皮时（T1）、单肺通气60 min（T2）、膨肺后60 min（T3）、术后1 h（T4）、4 h（T5）2、4 h（T6）采用酶联免疫吸附法（ELISA）测定血清肿瘤坏死因子（TNF-α）、IL-6、IL-8、IL-10的浓度。结果两组TNF-α、IL-6、IL-8、IL-10浓度在单肺通气60 min时均明显上升,TNF-α、IL-6和IL-8浓度于术后1 h达到高峰,IL-10浓度于术后4 h达到高峰。A组术后1、4、24 h时间点IL-10的水平均明显高于B组（P〈0.05）;B组单肺通气60 min至术后4 h各时点的TNF-α、IL-6和IL-8浓度增加幅度均明显高于A组（P〈0.05）。结论异丙酚和异氟烷均能促进肺癌根治术患者产生致炎性和抗炎性细胞因子,且异丙酚较异氟烷有明显的抑制炎症作用。

Effects of Propofol or Isoflurane Anesthesia on Perioperative Plasma Cytokine in Patients Undergoing Lobectomy for Lung Can

Objective To explore the effects of propofol or isoflurane anesthesia on perioperative plasma cytokine in patients undergoing lobectomy for lung cancer.Methods Thirty-eight patients undergoing lobectomy for lung cancer were randomly divided into group A(propofol) and group B(isoflurane),(each n=19).The plasma levels of TNF-α,IL-6,IL-8 and IL-10 were determined respectively with ELISA methods.Results The plasma levels of TNF-α,IL-6,IL-8,and IL-10 from T2 to T6 in the two groups were significantly increased.The plasma levels of TNF-α,IL-6,IL-8 were on the high-water mark at T4 and the plasma level of IL-10 was on the high-water mark at T5.The plasma level of IL-10 in group A from T4 to T6 were significantly higher than those in group B(P<0.05).The plasma levels of TNF-α,IL-6,IL-8 in group B from T2 to T5 were significantly higher than those in group A(P<0.05).Conclusions Propofol or isoflurane anesthesia can lead to take proinflammatory and antinflammatory cytokines in lung cancer patients,but propofol has more obviously antiflammatory effects.