乌司他丁对妇科腹腔镜手术患者NK细胞水平的影响

目的:探讨乌司他丁对妇科腹腔镜手术患者NK细胞水平的影响。方法:将40例择期全麻下行腹腔镜手术的不孕症患者随机分成乌司他丁组和对照组。乌司他丁组静脉滴注乌司他丁10万U+生理盐水100 ml,15 min滴完后静注芬太尼、丙泊酚和顺式阿曲库铵行气管插管控制呼吸,术中以丙泊酚及七氟醚维持麻醉,维持生命体征在正常水平,术毕待患者自主呼吸恢复、清醒后拔管。对照组静脉滴注生理盐水100 ml后麻醉,余同乌司他丁组。采集手术前(T0)、术毕(T1)、术后1天(T2)、术后3天(T3)的静脉血,采用流式细胞仪测定NK细胞(CD16+56)的水平。结果:与T0时比较,对照组NK细胞水平T1时无明显变化,T2、T3时明显下降(P<0.01);乌司他丁组NK细胞水平T1、T2时均无明显变化,T3时下降(P<0.05)。在T2、T3时对照组NK细胞水平明显低于乌司他丁组(P<0.05)。结论:相比乌司他丁组,对照组术后NK细胞水平下降明显,表明乌司他丁在妇科腹腔镜手术的应用对患者免疫功能有一定的保护作用。

Effect of ulinastatin on the level of NK cells of the patients after gynecologically laparoscopic surgery

Objective:To explore the effect of ulinastatin on the level of NK cells of the patients after gynecologically laparoscopic surgery.Methods:Forty infertile patients undergoing selective laparoscopic surgery under general anesthesia were randomly divided into ulinastatin group and control group.The patients in ulinastatin group were treated with intravenous drip of ulinastatin(100 000 U) and normal saline(100 ml) within 15 minutes,then fentanyl,propofol,and cis-atracurium were injected to control respiration by endotracheal intubation,propofol and sevoflurane were applied during surgery to maintain anesthesia,the vital signs were sustained at normal levels,after surgery,the tubes were removed when the patients recovered spontaneous respiration and regained consciousness.The patients in control group were treated with intravenous drip of normal saline(100 ml),then anesthesia was performed,the other therapies were the same as those used in ulinastatin group.The venous blood samples were collected before surgery(T0),at the end of surgery(T1),at one day after surgery(T2),and at three days after surgery(T3),flow cytometry was used to detect the level of NK cells(CD16+56).Results:Compared with T0,the level of NK cells at T1 in control group had no obvious change,the levels of NK cells at T2 and T3 decreased significantly(P<0.01);NK cells at T1 and T2 in ulinastatin group didn’t change significantly,while at T3,the level of NK cells decreased(P<0.05).The levels of NK cells at T2 and T3 in control group were significantly lower than those in ulinastatin group(P<0.05).Conclusion:Compared with ulinastatin group,the level of NK cells in control group after surgery decreased significantly,which indicates that ulinastatin plays a certain protective role in immune function of patients undergoing gynecologically laparoscopic surgery.