局麻和全麻对病人血清皮质醇,IL-1βIL-10水平影响的初步探讨.docVIP

PAGE PAGE 1 局麻和全麻对病人血清皮质醇、IL-1β IL-10水平影响的初步探讨 江苏连云港市妇幼保健院麻醉科（222006）英成光 缪江波 刘萍 摘要 目的：探讨了局麻和全身麻醉对手术病人血清皮质醇、IL-1β和IL-10水平的影响。方法：根据不同的麻醉方法对子宫癌病人分为硬膜外麻醉组（A组）和静吸复合全麻组（B组），每组30例。在麻醉诱导前、手术切皮和手术开始后1h抽取静脉血3ml，分别测定血清皮质醇、IL-1β和IL-10浓度。结果：A组血清Cortisol、IL-1β和IL-10含量在切皮和术中1h与术前比较有显著差别（P0.05）。B组血清Cortisol、IL-1β和IL-10含量无显著性差异（P0.05)。在切皮和术中1小时,B组Cortisol、IL-1β和IL-10含量比A组含量降低（P0.05）。结论:静吸复合麻醉能明显降低皮质醇、IL-1β和IL-10浓度。 关键词 全身麻醉 局部麻醉 皮质醇 白细胞介素-1β(IL-1β) 白细胞介素-10(IL-10) Influence of different type of Anesthesia (Regional Vs general)On serum cortisol IL-1βand IL-10 levels in gynecology patients Ying ChengGuang, Miao JiangBo, Liu Ping LianYunGang Women and Children Health Hospital，Jiangsu（222006） (Abstract )objective :To explore the influence of Anesthesia on charges of serum Cortisol IL-1βand IL-10 levels in gynecology patients. Methods : Serum cortisol (with RIA) and IL-1βIL-10 (with Elisa) levels were determined for 3 times in 30 patients operated under regional anesthesia and 30 patients operated under general Anesthesia (for carcinoma uterus).The levels were measured before induction of anesthesia, at the beginning of operation and 1hr later. Results: in patients under regional anesthesia, both the cortisol IL-1βand IL-10 levels increased significantly at the beginning of operation and 1hr later though dropped, remained Significantly higher than the levels before induction (p0.05). No significant charges of the levels were absorved in patients under general anesthesia throughout the operation, and the levels were as a whole significantly lower than the levels under regional anesthesia (p0.05).Conclusions: General Anesthesia(combined intravenous and inhalation)could abolish the lower of Serum Cortisol IL-1β and IL-10 levels during operation . (Key words) General anesthesia, Local anesthesia, Cortisol, Interleukin-1β(IL-1β), Interleukin-10(IL-10) 细胞因子在镇痛中的作用已广泛受到科研工作者的关注（1）。国内尚未见有局麻和全麻对血清皮质醇、IL-1β和IL-10影响的报道，为此，我们进行了探讨，现将我们的结果报告如下： 资料与方法 1.1临床一般资料 1.1.1病人组:60人.均为我院二年来经临床明确诊断的