医学论文-乌司他丁对老年胸部肿瘤患者围术期细胞因子的影响.docVIP

医学论文-乌司他丁对老年胸部肿瘤患者围术期细胞因子的影响 【摘要】? 目的 观察乌司他丁对老年胸部肿瘤患者围术期细胞因子的影响。方法 30例择期食管癌和贲门癌根治术患者随机分为两组：乌司他丁组（U组），切皮前将乌司他丁30万单位稀释至100 ml生理盐水中30 min静脉输注；对照组（C组），以等量生理盐水代替。分别于麻醉前（T1）、手术结束（T2）、术后1（T3）、3（T4）、5（T5）天，采集外周静脉血，以放射免疫法测定血浆白细胞介素6（IL6）、白细胞介素8（IL8）及肿瘤坏死因子α（TNFα）浓度。结果 C组IL6及TNFα在T2、T3、T4时段均较T1明显升高（P0.05）；而U组IL6及TNFα浓度在T4已降至术前水平（P0.05）。两组IL6及TNFα浓度比较在T2、T3、T4有显著性差异（P0.05）。C组IL8浓度在T2、T3较T1显著上升（P0.05）；而两组T2、T3时段IL8比较有显著性差异（P0.05）。结论 老年胸部肿瘤患者术中应用乌司他丁能有效抑制围术期IL6、IL8、及TNFα的释放。 【关键词】? 乌司他丁 细胞因子 食管癌和贲门癌根治术 ? ??? Abstract:Objective: To observe the effect of ulinastatin on perioprative cytokine in the elderly patients with thoracic tumor. Methods: Thirty patients undergone elective radical operation for esophogas and cardia cancer were randomly assigned into two groups with 15 cases each. The patients in the ulinastatn group (U) received ulinastatin 30ku in 30 min before skin incision, and the patients in the control group (C) the same volume of normal Saline as in group U instead of ulinastatin. Blood samples were taken before induction of anesthesia(T1), at the end of operation(T2), at 1 (T3) , 3 (T4) , 5 (T5) day after the end of surgery for the measurements of interleukin6(IL6), IL8 and tumor necrosis factor alpha (TNFα) by radioimmunoassay. Results: IL6 and TNFαincreased significantly during the period of T2～T4, compared with that at T1 in group C(P0.05). In group U, the IL6 and TNFα almost returned to baseline values at T4. At T2～T4, IL6 and TNFαwere significantly higher in group C than those in group U(P0.05). IL8 was strikingly higher at T2 and T3 than that at T1 in group C (P0.05), and IL8 at T2 and T3 in group C was also signifiantly higher compared with that in group U.Conclusion: Ulinastatin can effectively depresss the perioprative cytokine IL6,IL8,andTNFα in elderly patients with thoracic tumor. ??? Key words:ulinastatin; cytokine;? radical operation for esophogas and cardia cancer ??? 急性呼吸窘迫综合征（ARDS）是开胸手术后危重并发症之一,病死率高达50%～80%。近年来，各种细胞因子在A