切换至 "中华医学电子期刊资源库"

第五届中国出版政府奖音像电子网络出版物奖提名奖

中国科技核心期刊

中国科学引文数据库(CSCD)来源期刊

中华重症医学电子杂志 ›› 2017, Vol. 03 ›› Issue (01) : 46 -49. doi: 10.3877/cma.j/jssn.2096-1537.2017.01.010

所属专题: 镇痛镇静 文献

临床研究

术后镇痛对外伤性脾切除患者免疫细胞因子的影响
涂涛1,(), 王劲1   
  1. 1. 610500 成都医学院第一附属医院麻醉科
  • 收稿日期:2016-08-10 出版日期:2017-02-28
  • 通信作者: 涂涛
  • 基金资助:
    四川省应用基础研究计划项目(2014JY0123)

Effects of post-splenectomy analgesia on cytokines in trumatic splenic rupture patients

Tao Tu1,(), Jin Wang1   

  1. 1. Department of anesthesiology, the First Affiliated Hospital of Chengdu Medical College, Chengdu 610500, China
  • Received:2016-08-10 Published:2017-02-28
  • Corresponding author: Tao Tu
  • About author:
    Tu Tao,Email:
引用本文:

涂涛, 王劲. 术后镇痛对外伤性脾切除患者免疫细胞因子的影响[J/OL]. 中华重症医学电子杂志, 2017, 03(01): 46-49.

Tao Tu, Jin Wang. Effects of post-splenectomy analgesia on cytokines in trumatic splenic rupture patients[J/OL]. Chinese Journal of Critical Care & Intensive Care Medicine(Electronic Edition), 2017, 03(01): 46-49.

目的

观察术后镇痛对外伤性脾切除手术患者免疫细胞因子的影响。

方法

选取2015年1月至12月本院外伤性脾破裂行脾切除术患者44例,随机分为2组,镇痛组(25例)予以舒芬太尼术后镇痛,对照组(19例)术后泵注等量0.9%氯化钠溶液。采用视觉模拟疼痛评分法(VAS)评估镇痛效果,并采用酶联免疫吸附法(ELISA)分别在术前、术毕、术后12 h、24 h、48 h测定2组患者血浆中促炎性细胞因子IL-6、TNF-α以及抗炎性细胞因子IL-4、IL-10的含量。镇痛组与对照组VAS评分、血浆中IL-6、TNF-α与IL-4、IL-10指标比较采用独立样本t检验,性别、ASA分级比较采用χ2检验。

结果

镇痛组患者在各时间点VAS评分均低于对照组,差异均有统计学意义(t=-3.218、-3.615、-1.458、-2.773、-0.483,P均<0.05)。对照组的IL-6、TNF-α及IL-4、IL-10的含量在术后12 h、24 h与48 h均高于镇痛组,差异均有统计学意义(IL-6:t=-3.556、-6.020、-3.471;TNF-α:t=-2.146、-3.874、-2.778;IL-4:t=-4.975、-2.322、-0.604;IL-10:t=-6.090、-4.340、-2.773,P均<0.05)。

结论

有效的镇痛可缓解外伤性脾切除术后的免疫损伤与炎症反应。

Objective

To observe the effects of post-splenectomy analgesia on cytokines in traumatic splenic rupture patients.

Methods

44 cases of traumatic splenic rupture patients who underwent splenectomy were randomized into two groups, analgesic group was being infused with sufentanil for postoperative analgesia, while the control group was being infused with normal saline. The analgesic effects of each group were recorded with visual analog score (VAS) andserum concentration of IL-6, TNF-α, IL-4, and IL-10 were measured by ELISA before operation, after operation, at postoperative 12 h, postoperative 24 h, and postoperative 48 h in both groups.

Results

The VAS were lower than in the control group at each evaluating time point (t=-3.218, -3.615, -1.458, -2.773, -0.483, all P<0.05). Serum concentration of IL-6, TNF-α, IL-4, and IL-10 in the control group in time point postoperative 12 h, postoperative 24 h, and postoperative 48 h were higher than those in the analgesia group (IL-6: t=-3.556, -6.020, -3.471; TNF-α: t=-2.146, -3.874, -2.778; IL-4: t=-4.975, -2.322, -0.604; IL-10: t=-6.090, -4.340, -2.773, all P<0.05).

Conclusion

Effective analgesia can alleviate immune injury and inflammation after splenectomy in traumatic splenic rupture patients.

表1 镇痛组与对照组患者一般情况比较
表2 镇痛组与对照组术后各时间点VAS评分(±s
表3 镇痛组与对照组患者血浆IL-6水平比较(μ g/L,±s
表4 镇痛组与对照组患者血浆TNF-α水平比较(μ g/L,±s
表5 镇痛组与对照组患者血浆IL-4水平比较(μ g/L,±s
表6 镇痛组与对照组患者血浆IL-10水平比较(μ g/L,±s
[1]
Zhang XP, Chen HQ, Liu F, et al. Advances in researches on the immune dysregulation and therapy of severe acute pancreatitis[J]. J Zhejiang Univ Sci B, 2009, 10(7): 493–498.
[2]
Gu CY, Zhang J, Qian YN, et al. Effects of epidural anesthesia and postoperative epidural analgesia on immune function in esophageal carcinoma patients undergoing thoracic surgery[J]. Mol Clin Oncol, 2015, 3(1): 190–196.
[3]
Ramirez MF, Ai D, Bauer M, et al. Innate immune function after breast, lung, and colorectal cancer surgery[J]. J Surg Res, 2015, 194(1): 185–193.
[4]
张双静, 黄焕森, 李长科. 喷他佐辛术后镇痛对患者免疫及感染的影响[J]. 中华医院感染学杂志, 2014, 24(9): 2288–2290.
[5]
Aicher B, Peil H, Peil B, et al. Pain measurement: Visual Analogue Scale (VAS) and Verbal Rating Scale (VRS) in clinical trials with OTC analgesics in headache[J]. Cephalalgia, 2012, 32(3): 185–197.
[6]
Okabayashi T, Hanazaki K. Overwhelming postsplenectomy infection syndrome in adults - a clinically preventable disease[J]. World J Gastroenterol, 2008, 14(2): 176–179.
[7]
Mesia R, Gholami F, Huang H, et al. Systemic inflammatory responses in patients with type 2 diabetes with chronic periodontitis[J]. BMJ Open Diabetes Res Care, 2016, 4(1): e000260.
[8]
Liu YW, Yang T, Zhao L, et al. Activation of Adenosine 2A receptor inhibits neutrophil apoptosis in an autophagy-dependent manner in mice with systemic inflammatory response syndrome[J]. Sci Rep, 2016, 20(6): 33614.
[9]
吴育, 徐桂萍, 石文剑, 等. 氯胺酮超前镇痛对患者围术期血管紧张素Ⅱ及白细胞介素-2 的影响[J]. 西部医学, 2010, 22(7): 1211–1213.
[10]
Vethanayagam RR, Yang W, Dong Y, et al. Toll-like receptor 4 modulates the cochlear immune response to acoustic injury[J]. Cell Death Dis, 2016, 7(6): e2245.
[11]
Abdul-Aziz M, Tsolaki AG, Kouser L, et al. Complement factor H interferes with Mycobacterium bovis BCG entry into macrophages and modulates the pro-inflammatory cytokine response[J]. Immunobiology, 2016, 221(9): 944–952.
[12]
Moen SH, Westhrin M, Zahoor M, et al. Caspase-8 regulates the expression of pro- and anti-inflammatory cytokines in human bone marrow-derived mesenchymal stromal cells[J]. Immun Inflamm Dis, 2016, 4(3): 327–337.
[13]
Jeong DH, Kim KB, Kim MJ, et al. Skipjack tuna (Katsuwonus pelamis) eyeball oil exerts an anti-inflammatory effect by inhibiting NF-κB and MAPK activation in LPS-induced RAW 264.7 cells and croton oil-treated mice[J]. Int Immunopharmacol, 2016, 40: 50–56.
[14]
Keswani T, Sarkar S, Sengupta A, et al. Role of TGF-β and IL-6 in dendritic cells, Treg and Th17 mediated immune response during experimental cerebral malaria[J]. Cytokine, 2016, 88: 154–166.
[15]
Sainoh T, Orita S, Miyagi M, et al. Interleukin-6 and interleukin-6 receptor expression, localization, and involvement in pain-sensing neuron activation in a mouse intervertebral disc injury model[J]. J Orthop Res, 2015, 33(10): 1508–1514.
[16]
Mihara M, Hashizume M, Yoshida H, et al. IL-6/IL-6 receptor system and its role in physiological and pathological conditions[J]. Clin Sci (Lond), 2012, 122(4): 143–159.
[17]
洪彬源, 刘洪珍, 潘晓梅, 等. 多模式的镇痛方法对结肠癌根治术患者的免疫功能的影响[J]. 免疫学杂志, 2016, 32(4): 351–355.
[18]
Peake ST, Bernardo D, Mann ER, et al. Mechanisms of action of anti-tumor necrosis factor α agents in Crohn′s disease[J]. Inflamm Bowel Dis, 2013, 19(7): 1546–1555.
[19]
Ley S, Weigert A, Hériché JK, et al. RNAi screen in apoptotic cancer cell-stimulated human macrophages reveals co-regulation of IL-6/IL-10 expression[J]. Immunobiology, 2013, 218(1): 40–51.
[20]
Nathan N, Preux PM, Feiss P, et al. Plasma interleukin-4, interleukin-10, and interleukin-13 concentrations and complications after coronary artery bypass graft surgery[J]. J Cardiothorac Vasc Anesth, 2000, 14(2): 156–160.
[21]
Zhou HY, Yan J, Fang L, et al. Change and significance of IL-8, IL-4, and IL-10 in the pathogenesis of terminal Ileitis in SD rat[J]. Cell Biochem Biophys, 2014, 69(2): 327–331.
[22]
Akural EI, Salomäki TE, Bloigu AH, et al. The effects of pre-emptive epidural sufentanil on human immune function[J]. Acta Anaesthesiol Scand, 2004, 48(6): 750–755.
[1] 杨桂清, 孟静静. 哺乳期亚临床乳腺炎的研究进展[J/OL]. 中华乳腺病杂志(电子版), 2024, 18(06): 376-379.
[2] 张洁, 罗小霞, 余鸿. 系统性免疫炎症指数对急性胰腺炎患者并发器官功能损伤的预测价值[J/OL]. 中华普外科手术学杂志(电子版), 2025, 19(01): 68-71.
[3] 母德安, 李凯, 张志远, 张伟. 超微创器械辅助单孔腹腔镜下脾部分切除术[J/OL]. 中华普外科手术学杂志(电子版), 2025, 19(01): 14-14.
[4] 梁孟杰, 朱欢欢, 王行舟, 江航, 艾世超, 孙锋, 宋鹏, 王萌, 刘颂, 夏雪峰, 杜峻峰, 傅双, 陆晓峰, 沈晓菲, 管文贤. 联合免疫治疗的胃癌转化治疗患者预后及术后并发症分析[J/OL]. 中华普外科手术学杂志(电子版), 2024, 18(06): 619-623.
[5] 张志兆, 王睿, 郜苹苹, 王成方, 王成, 齐晓伟. DNMT3B与乳腺癌预后的关系及其生物学机制[J/OL]. 中华普外科手术学杂志(电子版), 2024, 18(06): 624-629.
[6] 赖全友, 高远, 汪建林, 屈士斌, 魏丹, 彭伟. 三维重建技术结合腹腔镜精准肝切除术对肝癌患者术后CD4+、CD8+及免疫球蛋白水平的影响[J/OL]. 中华普外科手术学杂志(电子版), 2024, 18(06): 651-654.
[7] 林逸, 钟文龙, 李锴文, 何旺, 林天歆. 广东省医学会泌尿外科疑难病例多学科会诊(第15期)——转移性膀胱癌的综合治疗[J/OL]. 中华腔镜泌尿外科杂志(电子版), 2024, 18(06): 648-652.
[8] 方辉强, 黄杰, 随冰琰. 腰方肌阻滞与腹横肌平面阻滞对腹股沟疝腹腔镜手术患者术后镇痛效果的影响[J/OL]. 中华疝和腹壁外科杂志(电子版), 2024, 18(06): 697-702.
[9] 王大伟, 陆雅斐, 皇甫少华, 陈玉婷, 陈澳, 江滨. 间充质干细胞通过调控免疫机制促进创面愈合的研究进展[J/OL]. 中华细胞与干细胞杂志(电子版), 2024, 14(06): 361-366.
[10] 杨建辉, 段文斌, 马忠志, 卿宇豪. 腹腔镜下脾部分切除术[J/OL]. 中华肝脏外科手术学电子杂志, 2025, 14(02): 314-314.
[11] 卓文锋, 曾桂芳, 杨思加, 赵家立, 邹宝嘉, 白子锐, 林恩, 李坚. 腹腔镜巨脾切除术:逐步打破的手术壁垒[J/OL]. 中华肝脏外科手术学电子杂志, 2024, 13(06): 783-788.
[12] 魏志鸿, 刘建勇, 吴小雅, 杨芳, 吕立志, 江艺, 蔡秋程. 肝移植术后急性移植物抗宿主病的诊治(附四例报告)[J/OL]. 中华肝脏外科手术学电子杂志, 2024, 13(06): 846-851.
[13] 董佳, 王坤, 张莉. 预后营养指数结合免疫球蛋白、血糖及甲胎蛋白对HBV 相关慢加急性肝衰竭患者治疗后预后不良的预测价值[J/OL]. 中华消化病与影像杂志(电子版), 2024, 14(06): 555-559.
[14] 谭瑞义. 小细胞骨肉瘤诊断及治疗研究现状与进展[J/OL]. 中华临床医师杂志(电子版), 2024, 18(08): 781-784.
[15] 王昌前, 林婷婷, 宁雨露, 王颖杰, 谭文勇. 光免疫治疗在肿瘤领域的临床应用新进展[J/OL]. 中华临床医师杂志(电子版), 2024, 18(06): 575-583.
阅读次数
全文


摘要