【摘要】 目的:探讨右美托咪啶对肝癌切除术患者术围术期细胞免疫功能的影响。方法:择期行肝癌切除术患者60例,年龄40⁶5岁,体重50⁸0 kg,ASA分级Ⅰ-Ⅱ。按照随机数字表法分为两组,每组各30例:右美托咪啶组（D组）和对照组（C组）。麻醉诱导前15 min,D组静脉泵注右美托咪啶0.5μg/kg（10min内泵完）,继之以0.4μg/（kg·h）速度维持至关腹;C组以相同速度静脉泵注等量生理盐水。两组患者分别于术前（T₀）、术毕（T₁）、术后1 d（T₂）采集颈内静脉血4 mL,采用流式细胞仪测定T淋巴细胞亚群CD3+、CD4+、CD8+以及NK细胞的水平,计算CD4+/CD8+的比值;并采用ELISA法测定血浆IL-2、IL-10浓度。结果:与T₀时比较,C组T₁、T₂时CD3+、CD4+、CD4+/CD8+比值、NK细胞水平明显降低;D组T₁、T₂时CD3+、CD4+、CD4+/CD8+比值明显降低（P<0.05）;与C组比较:D组T₁、T₂时CD3+、CD4+、NK细胞水平升高（P<0.05）,D组在T₁、T₂时IL-2明显增高,而IL-10水平明显降低（P<0.05）。结论:右美托咪定可减轻肝癌切除术患者手术创伤导致的术后细胞免疫功能抑制。更多还原

【Abstract】 Objective To investigate the effect of dexmedetomidine on perioperative cell immune function in patients undergoing hepatoma surgery.Methods Sixty patients（40-65 y/o,50-80 kg body weight,ASA grading Ⅰ-Ⅱ）with hepatoma were allocated into two groups each containing 30 patients:control group（group C）and dexmedetomidine group（group D）.15 minutes before anesthesia induction,a loading dose of dexmedetomidine 0.5 μg/kg was injected intravenously,followed by infusion at 0.4μg（/kg·h）until the end of operation in group D.The equal volume of normal saline was administered in group C.Blood samples were obtained from jugular vein before induction of anesthesia（T₀）,the end of operation（T₁）and 24 h after the end of surgery（T₂）for detections of the levels of T lymphocyte subsets（CD3+,CD4+,CD8+）and NK cells by flow cytometry.CIM+/CD8+ratio was calculated.Serum IL-2 and IL-10 were detected by ELISA methods.Results When compared with the baseline value（T₀）,the levels of CD3+,CD4+,CD4+/CD8+ratio and NK cells significantly decreased at T₁and T₂in group C,and the levels of CD3+ and CD4+ also significantly decreased at T₁and T₂in group D（P<0.05）.Compared with group C,the levels of CD3+,CD4+,NK cells and IL-2 at T₁and T₂were significantly higher in group D,and level of IL-10 at T₁and T₂were significantly lower in group D（P<0.05）.ConclusionDexmedetomidine could improve the postoperative suppression of immune function in patients undergoing hepatoma surgery.Key wordsDexmedetomidineHepatoma surgeryImmune function更多还原