乌司他丁对颈椎手术围手术期病人免疫功能的影响

目的:探讨乌司他丁对颈椎手术围手术期病人免疫功能的影响。方法:30例颈椎手术病人随机分为2组,每组15例。治疗组在麻醉前至手术开始后2 h内,予乌司他丁10万U+氯化钠注射液100 mL,静脉滴注;术后3 d每日予乌司他丁10万U+氯化钠注射液100 mL,静脉滴注,bid;对照组在相同时段静脉滴注氯化钠注射液100 mL。结果:治疗组术后d 1时的NK细胞数目升高(12±s6)×106.L-1,白细胞介素2升高(244±68)ng.L-1,白细胞介素2受体升高(256±78)ng.L-1,与手术当日比较均有非常显著差异(P<0.01),且上升幅度明显高于对照组(P<0.01)。而白细胞介素6浓度下降(7±3)ng.L-1,低于对照组(3.0±1.7)ng.L-1(P<0.01)。2组均未出现不良反应。结论:颈椎手术围手术期使用乌司他丁可能是维持或提升病人术后免疫功能的安全、有效途径。

Effect of ulinastatin on patients' immune function in cervical perioperative phase

AIM: To explore the effect of ulinastatin on patients'immune function in the perioperative phase of cervical operation. METHODS: Thirty patients intend to have cervical operation were equally divided into two groups randomly.The patients in the therapeutic group were treated with ulinastatin 100 kU in sodium chloride injection 100 mL,before the beginning of anesthesia up to 2 h after operation.Again ulinastatin 100 kU in sodium chloride injection 100 mL were used twice a day in the following 3 d,simultameously sodium chloride injection 100 mL were administrated in patients of the control group. RESULTS: The number of natural killer(NK) cells increased((12±)s 6)×10~6·L~(-1),the concentration of IL-2 increased(244±68) ng·L~(-1) and IL-2R increased(256±78) ng·L~(-1) in the therapeutic group 1 d after operation.All were higher than those in the operation day(P<0.01),and were significantly higher than those of control group(P<0.01).But the concentration of IL-6 in the therapeutic group was significantly decreased(7±3) ng·L~(-1),lower than that in the control group((3.0±1.7) ng·L~(-1),P<0.01).No obvious adverse reactions occurred in both groups. CONCLUSION: Using ulinastatin in the perioperative phase of cervical operation maybe effective and safe to maintain or elevate the patient's immune function after operation.