Effects of low dose dexmedetomidine combined with ulinastatin on immune function and stress response in patients with lung cancer

doi:10.12092/j.issn.1009-2501.2019.01.014

Abstract

Abstract:

AIM: To observe the effect of low dose dexmedetomidine combined with ulinastatin on immune function in patients with lung cancer. METHODS:A total of 120 patients with lung cancer scheduled to undergo operation were randomly divided into group A, B, C, D with 30 cases in each group. Before anesthesia induction, the patients in group B and group D received intravenous 0.3 μg·kg^-1·h^-1 dexmedetomidine after 0.3 μg/kg bolus. The patients in group C and group D received intravenous 200 000 U ulinastatin. The patients in group A received intravenous equal dose of saline. The levels of CD3+, CD4+, CD4+/CD8+ were determined before anesthesia (T0), 1 h after operation began (T1), 24 h (T2) after operation. The mean arterial pressure (MAP) and HR were also observed at T0, during tracheal intubation and extubation. The consumption of sevoflurane and remifentanil and the incident of bradycardia, hypotension and hypertension during operation were recorded. RESULTS:The levels of CD3+, CD4+ and CD4+/CD8+ of T1 and T2 were lower than those of T0 in group A, B and C (P＜0.05). At T1 and T2, the levels of CD3+, CD4+ and CD4+/CD8+ in group B and group C were higher than those in group A (P＜0.05), while those in group D were higher than those in other groups (P＜0.05). The MAP and HR of tracheal intubation and extubation were higher than those of T0 in group A and group C (P＜0.05). Compared with group A and group C, the MAP and HR of tracheal intubation and extubation were lower in group B and group D (P＜0.05). The consumption of sevoflurane and remifentanil and the incident of hypertension were lower in group B and group D than those in group A and group C (P＜0.05). CONCLUSION:Low dose dexmedetomidine combined with ulinastatin can improve perioperative immune function, inhibit stress response during tracheal intubation and extubation, and reduce the consumption of anesthetic drugs in patients with lung cancer.

Key words: dexmedetomidine, ulinastatin, lung cancer, immune function, stress response

CLC Number:

R614
R734.2

YUAN Jing, SUN Jingxue, HUANG Daiqiang, YUAN Lin, DING Dengfeng. Effects of low dose dexmedetomidine combined with ulinastatin on immune function and stress response in patients with lung cancer[J]. Chinese Journal of Clinical Pharmacology and Therapeutics, 2019, 24(1): 83-88.

References

［1］Yao X,Willianmson C,Adalsteinsson VA,et al.Tumor cells are dislodged into the pulmonary vein during lobectomy［J］.J Thorac Cardiovasc Surg,2014,148（6）:3224-3231.
［2］Byrne K，Levins KJ，Buggy DJ. Can anesthetic-analgesic technique during primary cancer surgery affect recurrence or metastasis［J］. Can J Anaesth，2016，63（2）：184-92.
［3］Sekandarzad MW，van Zundert AAJ，Lirk PB，et al. Perioperative Anesthesia Care and Tumor Progression［J］. Anesth Analg，2017，124（5）：1697-1708.
［4］石波，张薇薇. 右美托咪定对心血管疾病手术患者围术期细胞免疫功能的影响［J］. 空军医学杂志，2018，28（3）：174-177.
［5］龙谦，罗猛，许川，等. 乌司他丁对老年胸腔镜辅助肺叶切除患者免疫功能及认知功能的影响［J］. 中国老年学杂志，2018，4（38）：1887-1880.
［6］陈阳，马玉恒，刘帆，等. 右美托咪定输注对神经介入手术患者全麻恢复期苏醒质量影响［J］. 现代仪器与医疗，2016，22（1）：50-51，106.
［7］姜鹏，刘凯，王若峥. T细胞免疫与肿瘤关系研究进展［J］. 新疆医科大学学报，2015，38（1）：21-25.
［8］王景胜，刘正君，陈楠，等. 流式细胞仪检测恶性淋巴瘤患者外周血Ｔ细胞亚群的临床研究［J］. 实用肿瘤学杂志，2017，31（5）：431-435.
［9］Cai QH, Tang Y, Fan SH, et al. In vivo effects of dexmedetomidine on immune function and tumor growth in rats with ovarian cancer through inhibiting the p38MAPK/NF-κB signaling pathway［J］. Biomed Pharmacother, 2017, 10(95): 1830-1837.
［10］周志鹏，宋歌，王航，等. 右美托咪定对结肠癌根治术患者围术期应激反应及细胞免疫功能的影响［J］. 中国免疫学杂志，2017，33（11）：1694-1698.
［11］黄以庭，罗慧，冯雅薇，等. 右美托咪定对肝癌患者围术期细胞免疫功能的影响［J］. 实用医学杂志，2017，33（12）：2016-2018.
［12］邢玉英，齐少霞，赵雪莲，等. 芬太尼、舒芬太尼和瑞芬太尼对人脐血树突状细胞免疫功能影响的比较［J］. 中华麻醉学杂志，2012，32（11）：1363-1366.
［13］陈亦蛟，梁敏，朱韵甜，等. 丙泊酚和七氟烷对腹腔镜结直肠癌根治术患者围手术期免疫功能的影响［J］. 中华医学杂志，2015，95（42）：3440-3444.
［14］汪博. 右美托咪定应用于开胸肺癌根治术对患者围术期应激反应的影响［J］.实用癌症杂志，2017, 32（8）：1291-1293.
［15］冯康平，孙玉平，南细林，等. 右美托咪定伍用麻黄素对老年患者血流动力学的影响［J］. 广东医学，2018，39（9）：1294-1296.
［16］Satomoto M, Suzuki A, Uchida T, et al. Potential influence of pre and intraoperative factors on postoperative recurrence and survival in patients undergoing radical resection of esophageal cancer［J］. Masui, 2014, 63(12): 1344-1349.
［17］Villarroel JP, Guan Y, Werlin E, et al. Hemorrhagic shock and resuscitation are associated with peripheral blood mononuclear cell mitochondrial dysfunction and immunosuppression［J］. J Trauma Acute Care Surg, 2013, 75(1): 24-31.
［18］Alieva M, van Rheenen J, Broekman MLD. Potential impact of invasive surgical procedures on primary tumor growth and metastasis［J］. Clin Exp Metastasis, 2018, 35(4): 319-331.
［19］陶广华，张随随，朱玲钰，等. 乌司他丁的药理作用机制及临床应用进展［J］.中国药房，2017，28（35）：5020-5023.
［20］Momosaki K, Ishibashi N, Yoshida S, et al. Effect of preoperative administration of methylpredonisolone and ulinastatin on tumor cell metastasis after surgical stress［J］. Kurume Med J, 2014, 60(3/4): 79-88.
［21］李景铧，李前进，钱锋. 不同剂量乌司他丁对胃癌患者腹腔镜术后免疫功能及炎症反应的影响［J］. 中国现代普通外科进展，2016，9（7）：531-535.
［22］路敏，孙伟伟，张爱荣. 乌司他丁对腹腔镜结直肠癌手术患者免疫功能和肝肾功能的影响［J］. 当代医学，2016，22（9）：154-156.

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