Smith C, Erasmus P J, Myburgh K H
Department of Physiological Sciences, Stellenbosch University, Matieland, South Africa.
J Int Med Res. 2006 Nov-Dec;34(6):603-11. doi: 10.1177/147323000603400605.
The effect of acute pre-surgery dexamethasone treatment on the inflammatory immune and endocrine responses to orthopaedic surgery was investigated. Whole blood samples were obtained before and 5 days after surgery for immune analysis, and serum was obtained before and 6 h, 3 days and 5 days after surgery for endocrine assessment. Dexamethasone did not affect the post-surgery granulocyte response, but inhibited the increase in monocyte count (an average increase of 38.5% was seen in the control group). Peak C-reactive protein concentration (3 days after surgery) was 51.4% lower in the dexamethasone group than in the control group. Dexamethasone had a major effect on cortisol concentrations and the cortisol:testosterone and cortisol:dehydroepiandrosterone ratios, but no effect on anabolic hormone concentrations. In conclusion, acute pre-surgery dexamethasone treatment may have beneficial effects in the post-surgery period, by limiting the extent of systemic inflammation and the cortisol response.
研究了术前急性地塞米松治疗对骨科手术炎症免疫和内分泌反应的影响。术前及术后5天采集全血样本进行免疫分析，术前及术后6小时、3天和5天采集血清进行内分泌评估。地塞米松不影响术后粒细胞反应，但抑制单核细胞计数的增加（对照组平均增加38.5%）。地塞米松组术后3天C反应蛋白峰值浓度比对照组低51.4%。地塞米松对皮质醇浓度以及皮质醇：睾酮和皮质醇：脱氢表雄酮比值有重大影响，但对合成代谢激素浓度无影响。总之，术前急性地塞米松治疗可能通过限制全身炎症程度和皮质醇反应，在术后产生有益效果。
