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目的:观察不同剂量地佐辛对乳腺癌根治术患者术后T淋巴细胞亚群、NK细胞和IL-2和IL-10的浓度的影响。方法:40例乳腺癌根治术患者随机分为D1组和D2组,每组20例。麻醉诱导静注地佐辛0.2 mg/kg,术后患者静脉自控镇痛(PCIA)用地佐辛0.5 mg/kg(D1组)或0.8 mg/kg(D2组)。记录术后VAS评分,于麻醉前(T0)、术毕(T1)、术后1(T2)、3(T3)、7 d(T4)抽血检测T淋巴细胞亚群(CD3+、CD4+、CD8+水平以及CD4+/CD8+比值)和NK细胞水平以及血清IL-2和IL-10浓度。结果:D1组术后4 h时VAS高于D2组(P<0.05);D1组T1、T2时点CD3+、CD4+水平以及CD4+/CD8+比值和NK细胞水平高于D2组(P<0.05);D1组T2时血清IL-2浓度高于D2组(P<0.05)。结论:地佐辛对于乳腺癌根治术患者术后细胞免疫功能的抑制作用和细胞因子的调节作用呈剂量依赖性。
Objective: To observe the effect of different doses of dezocine on postoperative T lymphocyte subsets, NK cells and IL-2 and IL-10 in patients undergoing radical mastectomy. Methods: Forty cases of radical mastectomy were randomly divided into D1 group and D2 group, 20 cases in each group. Anesthesia induced intravenous dezocine 0.2 mg / kg and postoperative intravenous controlled analgesia (PCIA) with dexrazoxane 0.5 mg / kg (group D1) or 0.8 mg / kg (group D2). The postoperative VAS score was recorded and T lymphocyte subsets (CD3 +, CD4 +, CD8 +) were detected by blood sampling before anesthesia (T0), operation (T1), postoperative T1 Level and CD4 + / CD8 + ratio) and NK cell levels as well as serum IL-2 and IL-10 concentrations. Results: The VAS in D1 group was significantly higher than that in D2 group at 4 hours after operation (P <0.05). The levels of CD3 +, CD4 +, CD4 + / CD8 + and NK cells at T1 and T2 in D1 group were higher than those in D2 group (P <0.05) The level of serum IL-2 in D1 group was higher than that in D2 group (P <0.05). Conclusion: Dezocine can inhibit the cellular immune function and the regulation of cytokines in a dose-dependent manner in patients with radical mastectomy.