帕瑞昔布钠超前镇痛对烧伤患者热休克蛋白70和白细胞介素-6水平的影响

目的 研究帕瑞昔布钠超前镇痛对烧伤患者的镇痛作用以及对热休克蛋白70(HSP70)、白细胞介素-6(IL-6)水平的影响.方法 全身麻醉下行削痂植皮术患者60例,随机均分为三组:P组麻醉诱导前30 min静脉给予帕瑞昔布钠40 mg,PD组分别于麻醉诱导前30 min和手术结束前静脉给予帕瑞昔布钠40 mg,N组手术结束前30 min静脉给予生理盐水5 ml.检测患者麻醉前、术毕、术后6、12、24 h血浆HSP70和IL-6水平.观察患者术后2、4、8、12、24 h的VAS评分.结果 术后4、8、12、24hP组和PD组VAS评分均低于N组(P＜0.05).术后6、12h P组和PD组HSP70显著升高(P＜0.05),且明显高于N组(P＜0.05).术后6、12、24h P组和PD组IL-6明显降低(P＜0.05),N组明显升高(P＜0.05),且明显高于P组和PD组(P＜0.05).结论 帕瑞昔布钠超前镇痛能够增加烧伤患者HSP70的浓度,减少炎性因子IL-6的释放,并产生较好的镇痛效果.

Influnce of parecoxib on the expressions of plasma HSP70 and IL-6 in burned patients

Objective To investigate the effects of parecoxib on plasma heat shock protein 70(HSP70) and interleukin-6(IL-6) in burned patients.Methods Sixty moderately or severely burned patients undergoing tangential excision and skin grafting were randomly divided into three groups:group P,group PD and group N with 20 each.They were received 40 mg(30 min before anesthesia),80 mg parecoxib(40 mg 30 min before anesthesia and another 40 mg just before the end of surgery) or normal saline respectively.Blood samples were obtained before anesthesia,at the end of operation,6,12,and 24 h after operation.Serum HSP70 was determined by ELISA,and IL-6 level was assayed by the method of radioimmunoassay.Visual analogue scale (VAS) was recorded 4,8,12 and 24 h after the end of surgery.Results There was significant difference in VAS at 4,8,12,24 h postoperatively in group P or group PD when compared with group N(P<0.05).Compared with group N,plasma HSP70 in group P or group PD was markedly increased and IL-6 markedly decreased at the end of operation,6 h and 12 h after operation(P<0.05).Conclusion Parecoxib can increase plasma level of HSP70,suppress IL-6 and relieve postoperative pain in burned patients.