Pirttikangas C O, Salo M, Riutta A, Perttilä J, Peltola O, Kirvela O
Department of Anaesthesiology, University of Turku, Finland.
Anaesthesia. 1995 Apr;50(4):317-21. doi: 10.1111/j.1365-2044.1995.tb04607.x.
The present study evaluated the effects of propofol and its solvent Intralipid on the immune response and in vivo prostaglandin E2 production in patients during induction of anaesthesia and in healthy volunteers after Intralipid injection. Fifteen female patients (median age 48 years, ASA 1-2) scheduled for uterine dilatation and curettage were randomly assigned to two groups. In group 1 propofol (median dose 3.1 mg.kg-1) and in group 2 thiopentone (median dose 6.0 mg.kg-1) were injected intravenously over 60 s. Surgery was started after collection of the last blood sample. In the second part of this study, Intralipid 10% 0.3 ml.kg-1 was injected intravenously in eight healthy volunteers (four women and four men, median age 32 years) over 60 s. Plasma bicyclo-PGE2 concentrations increased during anaesthesia induction in both anaesthetic groups (p < 0.01). By contrast, no changes were seen in plasma bicyclo-PGE2 concentrations after Intralipid injection in volunteers. Lymphocyte proliferative responses to mitogens did not change during anaesthesia induction in patients. In volunteers, Intralipid injection caused a slight increase in T-cell percentages (p < 0.01) and unstimulated lymphocyte proliferative responses (p < 0.05), but it did not affect other lymphocyte subsets and immunoglobulin production. Intralipid and propofol were not found to be immunosuppressive at clinical doses used during anaesthesia induction.
本研究评估了丙泊酚及其溶剂脂肪乳剂对麻醉诱导期患者以及脂肪乳剂注射后健康志愿者免疫反应和体内前列腺素E2生成的影响。15例计划行刮宫术的女性患者（年龄中位数48岁，美国麻醉医师协会分级1 - 2级）被随机分为两组。第1组静脉注射丙泊酚（剂量中位数3.1 mg·kg-1），第2组静脉注射硫喷妥钠（剂量中位数6.0 mg·kg-1），注射时间均为60秒。采集最后一份血样后开始手术。在本研究的第二部分，8名健康志愿者（4名女性和4名男性，年龄中位数32岁）静脉注射10%脂肪乳剂0.3 ml·kg-1，注射时间为60秒。两个麻醉组在麻醉诱导期血浆双环前列腺素E2浓度均升高（p < 0.01）。相比之下，志愿者注射脂肪乳剂后血浆双环前列腺素E2浓度未见变化。患者在麻醉诱导期对丝裂原的淋巴细胞增殖反应未改变。在志愿者中，注射脂肪乳剂使T细胞百分比略有升高（p < 0.01），未刺激的淋巴细胞增殖反应增强（p < 0.05），但不影响其他淋巴细胞亚群和免疫球蛋白的产生。在麻醉诱导期使用的临床剂量下，未发现脂肪乳剂和丙泊酚具有免疫抑制作用。
