子宫切除术前给予右美托咪定对患者应激和免疫功能的影响

doi:10.13481/j.1671-587x.20150628

Abstract

Abstract:

Objective To explore the effect of dexmedetomidine on the stress and immunologic function in the patients undergoing uterectomy,and to provide an evidence for the medication in clinical anesthesia. Methods A total of 60 hysteromyoma patients who needed uterectomy were selected. All the patients were in ASAⅠ-Ⅱlevel.The patients were divided into observation group (n=30) and control group (n=30) according to administration of different types of drugs.Before anesthesia,the patients in observation group were given dexmedetomidine (l μg·kg^-1) with a concentration of 4 g·L^-1 for 10 min,while the patients in control group were given equal normal saline.The induction was performed 10 min after infusion pump.Sevoflurane and fentanyl were used for maintaining during the anesthesia.The blood samples of the patients in two groups before entering the operation room (T0),2h after operation (T1),and extubation after operation (T2) were collected.The serum cortisol (COR) and interleukin-2 (IL-2) concentrations,plasma T lymphocyte subpopulations and NK levels were detected. Results The differences of COR and IL-2 concentrations at T0 between two groups were not statistically significant (P>0.05).The COR concentrations at T2 in two groups were significantly higher than those at T0 (P<0.05).The COR concentration at T2 in observation group was significantly lower than that in control group (P<0.05).The serum IL-2 concentration was gradually decreased with the prolongation of time observation in two groups.The serum IL-2 concentration in observation group was significantly higher than that in control group (P<0.05).The differences of CD³⁺,CD⁴⁺,CD⁸⁺,CD⁴⁺/ CD⁸⁺,and NK levels at T0 between two groups were not statistically significant (P>0.05).The differences of CD⁸⁺ level in each time point between two groups were not statistically significant (P>0.05).The CD³⁺,CD⁴⁺,CD⁴⁺/ CD⁸⁺,and NK levels at T1 and T2 in control group were significantly lower than those at T0 (P<0.05).The CD³⁺,CD⁴⁺,CD⁴⁺/ CD⁸⁺,and NK levels at T2 in observation group were significantly higher than those in control group (P<0.05). Conclusion Dexmedetomidine assisting anesthesia can alleviate the postoperative stress reaction,and reduce the effect of anesthesia and operation wound on the cellular immune function.It is beneficial for the postoperative rehabilitation.

Key words: hysterectomy, dexmedetomidine, cortisol, interleukin-2, T lymphocyte subsets

CLC Number:

R614.2

LIU Hongmei, YANG Li. Influence of administration of dexmedetomidine before uterectomy in stress and immunologic function in patients[J].Journal of Jilin University Medicine Edition, 2015, 41(06): 1245-1248.

References

[1] 马立刚,王哲银.右美托咪定对腹腔镜子宫切除术患者循环及应激反应的影响 [J].广东医学,2011,32 (4):489-491.

[2] Boes S,Mahdi H,Khoury F,et al.Peripartum robotic-assisted laparoscopic hysterectomy after second-trimester pregnancy loss with placenta increta[J].Obstet Gynecol,2013,122 (2):440-444.

[3] Preslaski CR,Mueller SW,Wempe MF,et al.Stability of dexmedetomidine in polyvinyl chloride bags containing 0.9% sodium chloride injection [J].Am J Health Syst Pharm,2013,70 (15):1336-1341.

[4] 袁静,卢航青,郑康,等.右美托咪定对食管癌患者围术期免疫功能的影响 [J].中国老年学杂志,2013,33(1):59-61.

[5] 李爱梅,石翊飒,高瑞萍,等.不同剂量右美托咪定对脑膜瘤切除术患者术后认知功能的影响[J].临床麻醉学杂志,2013,29(7):655-668.

[6] Gill SE,Mills BB.Physician opinions regarding elective bilateral salpingectomy with hysterectomy and for sterilization[J].J Minim Invasive Gynecol,2013,20 (4):517-521.

[7] Aggarwal R,Bansal D,Bansal F,et al.Interleukin-5,interleukin-6,interleukin-8 and tumour necrosis factor-alpha levels obtained within 24h of admission do not predicthigh-risk infection in children with febrile neutropenia[J].Indian J Med Microbiol,2013,31 (3):226-229.

[8] Takehara Y,Satoh T,Nishizawa A,et al.Anti-tumoreffects of inactivated Sendai virus particles with an IL-2gene on angiosarcoma [J].Clin Immunol,2013,149(1):1-10.

[9] Park SH,Koo HJ,Sung YY,et al.The protective effect of Prunella vulgaris ethanol extract against vascular inflammation in TNF-α-stimulated human aortic smooth muscle cells[J].BMB Rep,2013,46 (7):352-357.

[10] 徐丽鲍,红光,张勇,等.右美托咪定对脓毒症大鼠早期和晚期炎症介质表达的影响[J].中国危重病急救医学,2012,24(9):562-564.

[11] 刘德昭,黄品婕,罗晨芳,等.脂微球化前列地尔对原位肝移植术患者肺损伤的影响[J].中华麻醉学杂志,2013,33(3):338-341.

[12] Jayaraman L,Sinha A,Punhani D.A comparative study to evaluate the effect of intranasal dexmedetomidine versus oral alprazolam as a premedication agent in morbidly obese patientsundergoing bariatric surgery[J].J Anaesthesiol Clin Pharmacol,2013,29 (2):179-182.

[13] 许忠玲,范冰冰,郭华.右美托咪定对重症颅脑损伤患者围术期血浆 S 蛋白100B 及炎性细胞因子的影响 [J].临床麻醉学杂志,2012,28 (9):872-874.

[14] Parikh DA,Kolli SN,Karnik HS,et al.A prospective randomized double-blind study comparing dexmedetomidine vs.combination of midazolam-fentanyl for tympanoplasty surgeryunder monitored anesthesia care [J].J Anaesthesiol ClinPharmacol,2013,29 (2):173-178.

[15] Sakthivel KM,Guruvayoorappan C.Acacia ferruginea inhibitstumor progression by regulating inflammatory mediators-(TNF-α,iNOS,COX-2,IL-1β,IL-6,IFN-γ,IL-2,GM-CSF) and pro-angiogenic growth factor-VEGF [J].Asian Pac J Cancer Prev,2013,14 (6):3909-3919.

[16] 傅钢兰,王萌,徐晓莹,等.右美托咪定对乳腺癌根治术患者围术期T淋巴细胞亚群的影响[J].中华实验外科杂志,2014,31(5):944-946.

[17] 文先杰,梁桦,刘远英,等.右美托咪定对烫伤大鼠细胞免疫功能的影响[J].中华麻醉学杂志,2014,34(10):1267-1270.

[18] 王宏志,韩冲芳.右美托咪定应用于老年患者肺癌根治术围术期中免疫功能的影响[J].中国药物与临床,2014,14(9):1274-1275.

Influence of administration of dexmedetomidine before uterectomy in stress and immunologic function in patients

PDF (PC)

Like

Knowledge

Abstract

Cite this article

share this article

References

Related Articles 15

Metrics

Comments

Recommended 10

[1]	Jing ZHANG,Shaoheng WANG,Pengfei LIU,Lei. GUAN. Effects of continuous infusion of dexmedetomidine on lactate metabolism and postoperative recovery in patients undergoing cytoreductive surgery combined with hyperthermic intraperitoneal chemotherapy [J]. Journal of Jilin University(Medicine Edition), 2022, 48(5): 1305-1313.
[2]	Lijun YAN,Shengquan TONG,Jing LIU,Dongmei GAO,Ping WU,Xi WANG. Effect of total saponins of clematis on T lymphocyte subsets in peripheral blood of rats with rheumatoid arthritis [J]. Journal of Jilin University(Medicine Edition), 2020, 46(6): 1241-1246.
[3]	FENG Xiunan, YUAN Yi, SU Kaisheng, JIANG Zhenyu. Distribution of peripheral blood T lymphocyte subsets of patients with systemic lupus erythematosus and its relationships with disease activity and prognosis [J]. Journal of Jilin University(Medicine Edition), 2019, 45(06): 1415-1421.
[4]	CHU Jinlong, XING Guizhi, SHEN Chunjin, LIU Xinying, CHU Zhijun. Influence of panax notoginseng saponins in T lymphocyte subsets in aplastic anemia mice and its hematopoietic effect [J]. Journal of Jilin University(Medicine Edition), 2019, 45(04): 807-812.
[5]	WANG Zhiguo, LIU Xueming, ZHOU Yuntao, TONG Shengquan, LI Yajuan, WANG Xi, CHEN Nanfang. Effects of Nourishing Kidney-Yin Prescription combined with glucocorticoid on T-lymphocyte subsets and inflammatory cytokines in mice with systemic lupus erythematosus [J]. Journal of Jilin University(Medicine Edition), 2019, 45(02): 336-341.
[6]	LI Fang, ZHANG Jian, HAO Xueqi, SHEN Si, JI Kai, SUN Yuning. Values of IL-27 and IFN-γ in pleural effusion in diagnosis of tuberculous pleuritis [J]. Journal of Jilin University(Medicine Edition), 2019, 45(02): 353-358.
[7]	HOU Hailong, TANG Ying, QU Xinglong, HUA Shucheng. Clinical effect of dexmedetomidine combined with non-invasive positive pressure ventilation in treatment of patients with AECOPD complicated with pulmonary encephalopathy and evaluation on its safety [J]. Journal of Jilin University(Medicine Edition), 2018, 44(05): 1014-1019.
[8]	CAO Xuefeng, ZHAO Liang, LIU Xudong, LI Yan, ZHEN Ruixin, DUAN Fengmei, LIU Yuling. Sedative effect of non-intravenous administration dexmedetomidine in pediatric patients underwent lower abdomen and limb surgery [J]. Journal of Jilin University Medicine Edition, 2018, 44(02): 388-393.
[9]	WANG Bo, SHEN Qianqian, ZHANG Hua, FENG Zhiying. Evaluation on postoperative analgesia efficacy of oxycodone combined with dexmedetomidine in patients underwent laparoscopic radical surgery of colon cancer [J]. Journal of Jilin University Medicine Edition, 2017, 43(06): 1231-1236.
[10]	HANG Min, REN Hongwei, QU Huiming, GENG Long. Clinical significance of IL-17 expression in serum of patients with psoriasis vulgaris and effects of shikonin on IL-6 and IL-23 production in IL-17-stimulated HaCaT cells [J]. Journal of Jilin University Medicine Edition, 2017, 43(05): 958-962.
[11]	DING Xianfei, YUAN Bo, XU Zhentao, ZHENG Shaohua, MA Yan, SHI Peina, SUN Tongwen. Dexmedetomidine and midazolam in procedural sedation:a systematic review of efficacy and safety [J]. Journal of Jilin University Medicine Edition, 2017, 43(04): 762-769.
[12]	CHEN Liyan, TANG Ying, ZHANG Li, SI Qin, XU Lijun. Detection of interleukin -22 in peripheral blood of patients with bronchial asthma and its clinical significance [J]. Journal of Jilin University Medicine Edition, 2017, 43(02): 349-352.
[13]	CHEN Hongtao, YANG Zhi, WU Shipin. Expression levels of IL-22 mRNA in PBMCs of patients at different HBV infection phases and their significances [J]. Journal of Jilin University Medicine Edition, 2016, 42(03): 551-555.
[14]	ZHANG Jingwen, ZHENG Lianwen, CHANG Xiaoyu, LIU Yongzheng, GAO Liwei, FU Lulu, XU Ying. Reflex anuria after radical hysterectomy:A case report and literature review [J]. Journal of Jilin University Medicine Edition, 2015, 41(04): 854-857.
[15]	WANG Hai-ying，LIANG Jie-ling，BI Yan-ling，ZHANG Ren-li，LUO Huai-qin，JIANG Zhou-mei，WEN An-min. Evaluation on ovarian function after hysterectomy by detection of serum anti-Mullerian hormone levels [J]. Journal of Jilin University Medicine Edition, 2014, 40(04): 875-879.