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丙泊酚输注麻醉与小手术中的免疫反应

Propofol infusion anaesthesia and immune response in minor surgery.

作者信息

Pirttikangas C O, Perttilä J, Salo M, Vainio O, Liukko-Sipi S

机构信息

Department of Anaesthesiology, Turku University Central Hospital, Finland.

出版信息

Anaesthesia. 1994 Jan;49(1):13-6. doi: 10.1111/j.1365-2044.1994.tb03304.x.

Abstract

This study was set up to evaluate the effects of propofol infusion anaesthesia on immunological function in minor surgery. Twenty-seven patients (median age 51 years, ASA 1-2) scheduled for minor breast surgery were randomly assigned to two groups. Anaesthesia was induced in group 1 with propofol 2.5 mg.kg-1 and maintained with propofol 12 mg.kg-1 x h-1 and 30% O2 in air, whereas in group 2 anaesthesia was induced with thiopentone 4 mg.kg-1 and maintained with 70% N2O in O2. Fentanyl and vecuronium were used in both groups. The percentages of T cells (p < 0.001), B cells (p < 0.01) and memory T cells increased (p < 0.01) in both groups. T helper cell percentages increased in the propofol but not in the thiopentone group (p < 0.05). The percentages of natural killer cells decreased from pre-induction values in both groups (p < 0.001). No changes were seen in lymphocyte proliferative responses. Minor breast surgery under propofol or conventional combined anaesthesia had only minor effects on the immune response. The higher percentage of T helper cells after propofol anaesthesia compared to conventional combined anaesthesia is beneficial, but its clinical importance remains to be determined.

摘要

本研究旨在评估丙泊酚输注麻醉对小手术免疫功能的影响。27例计划行小乳房手术的患者(中位年龄51岁,ASA 1-2级)被随机分为两组。第1组患者以2.5mg·kg-1丙泊酚诱导麻醉,并用12mg·kg-1·h-1丙泊酚和空气中30%氧气维持麻醉;而第2组患者以4mg·kg-1硫喷妥钠诱导麻醉,并用氧气中70%氧化亚氮维持麻醉。两组均使用芬太尼和维库溴铵。两组患者的T细胞(p<0.001)、B细胞(p<0.01)和记忆T细胞百分比均升高(p<0.01)。丙泊酚组辅助性T细胞百分比升高,硫喷妥钠组则未升高(p<0.05)。两组患者自然杀伤细胞百分比均较诱导前值降低(p<0.001)。淋巴细胞增殖反应未见变化。丙泊酚麻醉或传统联合麻醉下的小乳房手术对免疫反应仅有轻微影响。与传统联合麻醉相比,丙泊酚麻醉后辅助性T细胞百分比更高是有益的,但其临床重要性仍有待确定。

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