文献类型：期刊文献

中文题名：右美托咪定对老年全膝置换术患者围手术期免疫功能的影响

英文题名：Effects of dexmedetomidine on immune function of elderly patients receivings total knee arthroplasty

作者：杨言苹[1];于秋爽[1];白俊嫄[1]

第一作者：杨言苹

机构：[1]甘肃中医药大学附属医院麻醉手术科,甘肃兰州730020

第一机构：甘肃中医药大学第二附属医院

年份：2021

卷号：47

期号：3

起止页码：12

中文期刊名：兰州大学学报（医学版）

外文期刊名：Journal of Lanzhou University（Medical Sciences）

收录：CSTPCD

基金：甘肃省卫生行业科研计划项目(GSWSKY-2014-48)。

语种：中文

中文关键词：右美托咪定;老年患者;全膝置换术;免疫功能

外文关键词：dexmedetomidine;elderly patient;total knee arthroplasty;immune function

摘要：目的观察右美托咪定对老年全膝置换术(TKA)患者围手术期免疫功能的影响。方法选择行单侧TKA患者60例,随机分为右美托咪定组(D组)和对照组(C组),每组30例。D组患者麻醉后给予右美托咪定0.5μg/(kg·h)持续泵注,C组患者给予等量生理盐水。分别于麻醉前10 min (T_(0))、术毕即刻(T_(1))、术后24 h (T_(2))、术后48 h (T_(3))抽取外周静脉血,采用流式细胞仪测定T淋巴细胞亚群(CD3+、CD4+、CD8+、CD4+/CD8+)数量;并采用酶联免疫分析法测定T_(0)~T_(3)血清炎性因子(IL-2、IL-10)质量浓度。结果 T_(1)、T_(2)时,2组患者CD3+、CD4+、CD4+/CD8+明显低于T_(0)时,且C组患者明显低于D组患者(P<0.05)。T_(1)、T_(2)、T_(3)时,C组患者IL-2质量浓度明显低于T_(0)时,且低于D组患者。T_(2)、T_(3)时C组患者IL-10质量浓度明显高于T_(0)时,且高于D组患者(P<0.05)。结论老年TKA患者术后存在一定的免疫功能紊乱,右美托咪定可以通过抑制围手术期应激反应,保护患者的免疫功能。
Objective To observe the effects of dexmedetomidine on the immune function of perioperative period in elderly patients receiving total knee arthroplasty(TKA). Methods Sixty patients undergoing unilateral knee arthroplasty were selected and assigned to two groups randomly: dexmedetomidine group(group D) and control group(group C) with 30 cases in each. Patients in group D were given 0.5 μg/(kg·h) of dexmedetomidine infusion after anesthesia until 20 min before the end of surgery, patients in group C were given normal saline in the same way as in group D. Flow cytometry was used to detect peripheral blood T lymphocytes(CD3+, CD4+, CD8+, CD4+/CD8+), at 10 min before anesthesia(T_(0)), immediately(T_(1)), 24 h(T_(2)) and 48 h(T_(3)) after surgery. Enzyme-linked immunosorbent assay was used to detect the levels of inflammatory cytokines concentration(IL-2, IL-10) at T_(0), T_(1), T_(2), T_(3). Results Compared with those at T_(0), the levels of CD3+,CD4+, CD4+/CD8+ were significantly lower at T_(1) and T_(2) in both groups, and the levels in group D were obviously higher than those in group C(P< 0.05). Compared with those at T_(0), the concentration of IL-2 was significantly lower at T_(1), T_(2), T_(3) and the concentration of IL-10 was higher at T_(2) and T_(3) in group C(P< 0.05).Compared with those in group D, the concentration of IL-2 was lower at T_(1) and T_(2) and the concentration of IL-10 was higher at T_(2) and T_(3) in group C(P< 0.05). Conclusion There is a certain degree of immunosuppression after TKA in elderly patients, dexmedetomidine can inhibit the perioperative stress response and protect the immune function of patients.