摘要
目的:探讨不同吸入麻醉药对老年患者红细胞免疫功能和流变性的影响.方法:45例拟在全麻下行腹腔镜胆囊切除的患者,随机分为异氟醚组、七氟醚组和地氟醚组.麻醉诱导插管后,异氟醚组以10～15mL/L异氟醚吸入,七氟醚组以40～60mL/L七氟醚吸入,地氟醚组以40～60mL/L地氟醚吸入,并间断给予芬太尼和维库溴铵静脉注射维持麻醉.分别在麻醉前(T1)、麻醉后30min(T2)、术后60min(T3)、术后24h(T4)4个时间点抽取肘静脉血.检测各时间点红细胞免疫功能[红细胞C3b受体花环率(RBC-C3bRR)、红细胞免疫复合物花环率(RBC-ICR)、CD35阳性红细胞百分率、红细胞超氧化物歧化酶(SOD)水平]和红细胞流变性(聚集指数、变形指数).结果:3组患者麻醉后30min,术后60min C3bRR均显著降低(P<0.05),RBC-ICR显著升高(P<0.05),术后24h恢复至麻醉前水平;3种麻醉药在不同时间点对红细胞免疫功能指标的影响无显著差异(P>0.05).3组患者各时点红细胞聚集指数均无明显变化(P>0.05);地氟醚组术中30min红细胞变形指数较麻醉前显著增大(P<0.05),术后60min恢复至麻醉前水平.结论:异氟醚、七氟醚、地氟醚麻醉可降低老年患者术中红细胞免疫功能,地氟醚可一过性降低红细胞的变形性.
AIM： To investigate the effects of different inhalation anesthetic agents on erythrocyte immune function and deformability in the elder patients. METHODS： Forty-five elder patients, who were scheduled to undergo laparoscopic cholecystectomy and ASA Ⅰ - Ⅱ, were randomized into 3 groups by different inhalation anesthetics ： isoflurane, sevoflurane, and desflurane during anaesthsia maintaining. All patients received no premedication. Anesthesia was induced using propofol, fentanul and vecuronium, and maintained with 10-15 mL/L isoflurane, 40-60 mL/L desflurane or sevoflurane. Blood of ulnar vein was taken suction at pre-anaesthesia （ T1 ） , 30 rain post-anaesthesia （ T2）, 60 min post-operation（T3 ）, 24 h post-operation（ T4 ） respectively. RBC- C3bRR, RBC-ICR, rate of CD35 positive cell and SOD and indexs of erythrocyte deformability and aggregation were measured at different time points. RESULTS： Decreased RBC-C3b RR and increased RBC-ICR were observed after 30 min-anaesthesia induction and 60 min post-operation （ P 〈 0.05 ）, and recovered after 24 h postorperation. All inhalation anesthetic agents had no significantly different effects on RBC-C3b RR, RBC-ICR and expression level of CD35 and SOD at each time point （ P 〉 0.05 ）. All inhalation anesthetic agents had no effects on index of erythrocyte aggregation at each time point （ P 〉 0.05 ）. Desflurane made significantly increased index of erythrocyte deformability after 30 min anaesthesia induction （P 〈 0.05 ）, which were recovered at 60 min postoperation. CONCLUSION： Isoflurane, sevoflurane and desflurane may decrease erythrocyte immune function and desflurane may alter erythrocyte deformability during anaesthesia and surgery.
出处
《第四军医大学学报》
北大核心
2008年第22期2072-2074,共3页
Journal of the Fourth Military Medical University
关键词
麻醉药
吸入
红细胞
免疫功能
流变性
anesthetics inhalation
erythrocytes
immune function
deformability
