脊髓和全身麻醉对促炎和抗炎细胞因子血清浓度的影响。

Effect of spinal and general anesthesia on serum concentration of pro-inflammatory and anti-inflammatory cytokines.

机构信息

Department of Anaesthesiology, Reanimatology and Intensive Medicine, University Hospital Center - Zagreb, Croatia.

出版信息

Immunobiology. 2012 Jun;217(6):622-7. doi: 10.1016/j.imbio.2011.10.018. Epub 2011 Nov 3.

DOI:10.1016/j.imbio.2011.10.018

PMID:22217966

Abstract

BACKGROUND

Surgery induces release of neuroendocrine hormones, cytokines and acute phase proteins. The aim of this study was to assess the effect of spinal and general anesthesia on serum concentration of pro-inflammatory and anti-inflammatory cytokines, and cytokines which are secreted by Th1 helper lymphocytes.

METHODS

30 patients with American Society of Anesthesiologists status I and II who were scheduled for TURP (Transurethral Resection of the Prostata) were anesthetized in regional (spinal) or general anesthesia. Peripheral venous blood samples were collected 2 h before surgery on the first, third and fifth postoperative days. We measured pro-inflammatory cytokines, anti-inflammatory cytokines and cytokines which are secreted by Th1 helper lymphocytes in order to establish differences in patients before and after surgery.

RESULTS

Statistically significant differences were found in serum levels of interleukin-2 (IL-2) between general and spinal anesthesia (p=0.043). The concentration of IL-2 was continuously elevated in general anesthesia, but not in spinal anesthesia. It is important to note that the preoperative serum IL-2 concentration in general anesthesia group was significantly higher in comparison to spinal anesthesia group (p=0.028). There was also statistically significant increase of interleukin-6 (IL-6) in spinal (p=0.043) and general anesthesia (p=0.03) in comparison to preoperative value.

CONCLUSION

Surgery-related postoperative release of the pro-inflammatory cytokine IL-6 was increased in patients after spinal and general anesthesia. In our study, increased levels of the typical Th1 cytokine IL-2 were found in patients anesthetized by general anesthesia compared to spinal anesthesia. Serum concentrations of other pro-inflammatory cytokines, anti-inflammatory cytokines and cytokines which are secreted by Th1 helper lymphocytes showed no statistical difference before and after surgery under general and spinal anesthesia.

摘要

背景

手术会引发神经内分泌激素、细胞因子和急性期蛋白的释放。本研究旨在评估脊髓和全身麻醉对促炎和抗炎细胞因子以及 Th1 辅助淋巴细胞分泌的细胞因子血清浓度的影响。

方法

30 名美国麻醉医师协会（ASA）I 级和 II 级患者拟行 TURP（经尿道前列腺切除术），在区域（脊髓）麻醉或全身麻醉下进行麻醉。分别于术前 2 小时、术后第 1、3、5 天采集外周静脉血样。我们测量了促炎细胞因子、抗炎细胞因子和 Th1 辅助淋巴细胞分泌的细胞因子，以确定手术前后患者之间的差异。

结果

全身麻醉和脊髓麻醉之间的白细胞介素-2（IL-2）血清水平存在统计学显著差异（p=0.043）。全身麻醉中 IL-2 浓度持续升高，但脊髓麻醉中没有。值得注意的是，全身麻醉组术前血清 IL-2 浓度明显高于脊髓麻醉组（p=0.028）。与术前值相比，脊髓麻醉（p=0.043）和全身麻醉（p=0.03）中白细胞介素-6（IL-6）也有统计学显著增加。