Pirttikangas C O, Salo M, Mansikka M, Grönroos J, Pulkki K, Peltola O
Department of Anaesthesiology, University of Turku, Finland.
Anaesthesia. 1995 Dec;50(12):1056-61. doi: 10.1111/j.1365-2044.1995.tb05951.x.
Earlier studies on propofol have shown increased percentages of T helper cells after minor surgery. In this study, the effects of propofol infusion anaesthesia on the immune response were compared with those of combined isoflurane anaesthesia in 30 patients (median age 47 years, ASA 1-2) undergoing major surgery. The total dose of propofol in the propofol infusion group of 15 women was 860 mg (range 540-1520 mg) and the median end-expiratory isoflurane concentration in the combined isoflurane group of 15 women was 0.6% (range 0.5-0.8). The following were measured; leucocyte and differential counts; percentages of lymphocyte subpopulations (CD3, CD4, CD8, CD19, CD16 and HLA-DR+CD3); phytohaemagglutinin-, concanavalin A-, and pokeweed mitogen-induced and unstimulated lymphocyte proliferation; plasma interleukin-6; serum group II phospholipase A2, C-reactive protein and cortisol concentrations. Measurements were made pre-operatively, at the end of the operation and on the first and fifth postoperative days. No statistically significant overall differences were observed in the immune response between the groups. The serum cortisol response was weaker in the propofol group than in the isoflurane group (p < 0.05). Time-related changes were seen within the groups.
早期关于丙泊酚的研究表明，小手术后辅助性T细胞的百分比会增加。在本研究中，对30例接受大手术的患者（年龄中位数47岁，美国麻醉医师协会分级1-2级），比较了丙泊酚输注麻醉与异氟烷复合麻醉对免疫反应的影响。丙泊酚输注组的15名女性患者丙泊酚总剂量为860毫克（范围540-1520毫克），异氟烷复合组的15名女性患者呼气末异氟烷浓度中位数为0.6%（范围0.5-0.8）。检测了以下指标：白细胞及分类计数；淋巴细胞亚群（CD3、CD4、CD8、CD19、CD16及HLA-DR+CD3）的百分比；植物血凝素、刀豆蛋白A及商陆有丝分裂原诱导的和未刺激的淋巴细胞增殖；血浆白细胞介素-6；血清II型磷脂酶A2、C反应蛋白及皮质醇浓度。在术前、手术结束时以及术后第1天和第5天进行测量。两组之间在免疫反应方面未观察到总体上具有统计学意义的差异。丙泊酚组的血清皮质醇反应比异氟烷组弱（p<0.05）。各研究组内均观察到了与时间相关的变化。
