Wang Y, Zhang J, Zhang S J
Department of Anesthesiology, the First Affiliated Hospital of Zhengzhou University, Zhengzhou, China.
Key-Disciplines Laboratory Clinical-Medicine Henan, Zhengzhou, China
J Biol Regul Homeost Agents. 2017 Jan-Mar;31(1):119-123.
Infectious or septic shock is induced when a toxic microorganism invades blood circulation in the human body. Emergency operation is an effective method for treating infectious shock in the early stages although the use of anesthesia is more complex due to the internal disorders caused by the disease. This study explored the effects of propofol and etomidate anesthesia on the cellular immune function (T lymphocyte subpopulation) of infectious shock patients, aiming to provide a basis for the selection of the proper anesthetic method. One hundred and twenty patients with infectious shock were selected and randomly divided into an observation and a control group. The control group were narcotized using propofol, while the observation group were narcotized using etomidate. The effects on the immune functions of patients and drug-related adverse reactions were compared between the two groups. Results demonstrated that the levels of CD3+ and CD4+ of the two groups were similar before anesthesia and the differences had no statistical significance (P 0.05). After anesthesia, the levels of both groups showed a tendency to decrease and the levels of CD3+ and CD4+ of the observation group were much higher than those of the control group in the different periods. The differences were statistically significant (P less than 0.05); the differences of CD8+ level and CD4+/CD8+ between the two groups had no statistical significance before anesthesia (P0.05); after anesthesia, CD8+ level and CD4+/CD8+ of the observation group were all much higher than those of the control group in the different periods and the differences had statistical significance (P less than 0.05). Therefore, the conclusion is that etomidate anesthesia has little influence on the immune functions of infectious shock patients in perioperative period and the incidence of adverse reaction is low, hence, worth clinical promotion.
当有毒微生物侵入人体血液循环时，会引发感染性或脓毒性休克。急诊手术是早期治疗感染性休克的有效方法，尽管由于疾病引起的体内紊乱，麻醉的使用更为复杂。本研究探讨丙泊酚和依托咪酯麻醉对感染性休克患者细胞免疫功能（T淋巴细胞亚群）的影响，旨在为选择合适的麻醉方法提供依据。选取120例感染性休克患者，随机分为观察组和对照组。对照组采用丙泊酚麻醉，观察组采用依托咪酯麻醉。比较两组对患者免疫功能的影响及药物相关不良反应。结果显示，两组麻醉前CD3+和CD4+水平相似，差异无统计学意义（P>0.05）。麻醉后，两组水平均呈下降趋势，且观察组在不同时期的CD3+和CD4+水平均高于对照组。差异有统计学意义（P<0.05）；两组麻醉前CD8+水平及CD4+/CD8+差异无统计学意义（P>0.05）；麻醉后，观察组在不同时期的CD8+水平及CD4+/CD8+均高于对照组，差异有统计学意义（P<0.05）。因此，结论是依托咪酯麻醉对感染性休克患者围手术期免疫功能影响小，不良反应发生率低，值得临床推广。
