天津医药

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丙泊酚和异氟醚对颅内肿瘤患者抗炎性因子的影响

王昆鹏1,2,宫建3,白宇2   

  1. 1.
    2. 中国医科大学附属第一医院
    3. 沈阳药科大学生命科学与生物制药学院
  • 收稿日期:2011-09-28 修回日期:2011-12-21 出版日期:2012-08-15 发布日期:2012-08-15
  • 通讯作者: 宫建

Effect of different anesthesia on Anti-inflammatory Cytokines in the intracranial neoplasms

  • Received:2011-09-28 Revised:2011-12-21 Published:2012-08-15 Online:2012-08-15

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摘要： 目的　观察丙泊酚、异氟醚对颅内肿瘤患者抗炎性因子白细胞介素-4（IL-4）、IL-10及IL-13的影响，并探讨丙泊酚脑保护作用的机制。 方法　择期全麻下行颅内肿瘤手术患者106例，年龄35~60岁，体重39~82kg，ASAⅠ或Ⅱ级，按性别随机分为丙泊酚组和异氟醚组，每组各53例，丙泊酚组采用血浆靶控输注丙泊酚3~6μg/mL，异氟醚组使用1% ~2%的异氟醚持续吸入，两组术中均按需静脉给予芬太尼和维库溴铵，并于手术结束前5 min分别停止丙泊酚输注和异氟醚吸入。两组均于麻醉诱导前（T0）、术后0 h（T1）、24 h（T2）和48 h（T3）各时点抽取静脉血，测定血清IL-4，IL-10，IL-13的含量。结果　丙泊酚组和异氟醚组患者血清IL-4、IL-10和 IL-13含量术后均呈上升趋势，各指标各时间点间差别均具有统计学意义（均P<0.01），其中T2、T3时丙泊酚组和异氟醚组IL-4、IL-10和 IL-13含量均较T0、T1时明显升高（均P<0.05）；丙泊酚组和异氟醚组比较，T0和T1时IL-4、IL-10和 IL-13含量差别均无统计学意义（均P>0.05）；T2、T3时，丙泊酚组IL-4、IL-10和 IL-13含量均较异氟醚组增多（均P<0.05）。 结论　丙泊酚靶控输注比异氟醚吸入可更好地增强颅内肿瘤患者术后抗炎性水平，这可能也是丙泊酚发挥脑保护作用的机制之一。

关键词: 丙泊酚, 异氟醚, 颅内肿瘤, 白细胞介素-4, 白细胞介素-10, 白细胞介素-13

Abstract: Objective To investigate the influence of anesthesia methods and anesthetics on anti-inflammatory cytokines in the intracranial neoplasms. Methods One hundred six ASA Ⅰ or Ⅱ patients undergoing for selective intracranial neoplasms surgery were divided randomly into two groups with 53 cases each. The patients in group P were given intravenous anesthesia with target controlled infusion of propofol 3~6μg/mL, those in group I received inhalation anesthesia with isoflurane 1% ~2%. IL-4, IL-10 and IL-13 were recorded before anesthesia, 0h, 24h, and 48h after operation. Results The serum levels of IL-4, IL-10 and IL-13 were significantly increased at 24h and 48h after operation compared with those before anesthesia in both groups (all P<0.05). The serum levels of IL-4, IL-10 and IL-13 were significantly higher in group P than those in group I at 24h and 48h after operation (all P<0.05). Conclusion The effect of propofol was better than sevoflurane in inhibiting inflammatory reaction in patients with intracranial neoplasms.

Key words: Propofol, isoflurane, intracranial neoplasms, IL-4, IL-10, IL-13