帕瑞昔布钠超前镇痛对肺癌根治术患者细胞免疫功能的影响

目的:研究帕瑞昔布钠超前镇痛对肺癌患者围术期细胞免疫功能的影响。方法:40例择期全麻下行肺癌根治术患者随机分为2组,Ⅰ组患者麻醉诱导前30min静脉给予帕瑞昔布钠40mg(稀释为5mL);Ⅱ组麻醉诱导前30min静脉给予生理盐水5mL,2组患者手术结束前10min静脉给予帕瑞昔布钠40mg(稀释为5mL)后均接PCIA(病人自控静脉镇痛)泵给予芬太尼镇痛。于麻醉前(T0),手术开始后2h(T1),术后24h(T2)、48h(T3)、120h(T4)5个时间点用流式细胞仪检测T淋巴细胞亚群(CD3+、CD4+、CD8+)及自然杀伤(NK)细胞。结果:与麻醉前比较,2组CD3+、CD4+、CD4+/CD8+在T1、T2、T3时和NK细胞在T1、T2、T3、T4时均明显降低(P<0.05)。与Ⅱ组比较,Ⅰ组CD3+、CD4+、CD4+/CD8+在T2、T3时和NK细胞在T2、T3、T4时下降幅度较小(P<0.05)。结论:帕瑞昔布钠超前镇痛能改善肺癌患者围术期的细胞免疫功能。

Effects of Preemptive Analgesia with Parecoxib Sodium on Cellular Immune Function in Patients Undergoing Radical Resection of Lung Carcinoma

OBJECTIVE：To study the effects of preemptive analgesia with parecoxib sodium on cellular immune function in patients undergoing radical resection of lung carcinoma. METHODS：Forty patients undergoing selective radical resection of lung carcinoma were randomly divided into two groups. Group Ⅰ were injected with 40 mg parecoxib sodium（diluted to 5 mL）and group Ⅱ were injected with 5 mL normal saline 30 min before anesthesia induction. Then both groups were injected with 40 mg parecoxib sodium（diluted to 5 mL）10 min before completing operation and received PCIA with fentanyl. T-lymphocyte subsets（CD3＋, CD4＋,CD8＋）and natural killer cells were measured by flow cytometry at five time points,i.e. before anesthesia induction（T0）,at 2 h after incision（T1）,24 h（T2）,48 h（T3）and 120 h（T4）after operation. RESULTS：Compared with T0,the values of CD3＋, CD4＋,CD4＋/CD8＋ at T1,T2,T3 and natural killer cells at T1,T2,T3,T4 decreased in both groups（P0.05）. The decrease of CD3＋,CD4＋,CD4＋/CD8＋ at T2,T3 and natural killer cells at T2,T3,T4 in groupⅠ were less than those in groupⅡ（P0.05）. CONCLUSION：Preemptive analgesia with parecoxib sodium can improve the cellular immune function in patients undergoing radical resection of lung carcinoma.