目的 探討舒芬太尼復合丙泊酚靶控輸注對宮頸癌根治術患者T細胞 17(Th17)/調節(jié)性 T 細胞(Treg)及氧化抗氧化系統的影響。方法 選取2019年10月-2021 年 10 月延安市人民醫(yī)院行宮頸癌根治術患者 80 例為研究對象,采用隨機數字表法分為對照組和試驗組,每組各 40 例,兩組患者均行全身麻醉下腹腔鏡宮頸癌根治術治療,術中對照組行芬太尼復合丙泊酚靶控輸注;試驗組行舒芬太尼復合丙泊酚靶控輸注。比較兩組麻醉前 1 h、麻醉后 1 h、手術結束后 1 h 血清 Th17/Treg 相關指標(Th17、Treg、Th17/Treg)、氧化抗氧化系統相關指標[超氧化物歧化酶(SOD)、丙二醛(MDA)、過氧化氫酶(CAT)]水平,分別于術畢、術后 6 h、術后 12 h 對兩組患者進行疼痛程度評分(VAS 評分)。結果 麻醉后 1 h、手術結束后 1 h 兩組血清 Treg 水平均較麻醉前 1 h 顯著降低(P<0.05),麻醉后 1 h、手術結束后 1 h 兩組血清 Th17、Th17/Treg水平均較麻醉前 1 h 顯著升高(P<0.05);試驗組麻醉后 1 h、手術結束后 1 h 血清 Treg 水平高于對照組,Th17、Th17/Treg水平低于對照組(P<0.05);麻醉后 1 h、手術結束后 1 h 兩組 SOD、CAT、MDA 水平均較麻醉前 1 h 升高,差異有統計學意義(P<0.05);試驗組麻醉后 1 h、手術結束后 1 h 血清 SOD、CAT 水平高于對照組,MDA 水平低于對照組(P<0.05);試驗組術后 6、12 h VAS 評分均顯著低于對照組(P<0.05)。結論 與芬太尼復合丙泊酚靶控輸注比較,宮頸癌患者根治術中采用舒芬太尼復合丙泊酚靶控輸注能降低手術及麻醉對患者 Th17/Treg 及氧化抗氧化系統的影響,改善鎮(zhèn)痛效果。

Objective To investigate effect of sufentanil compounded with propofol target-controlled infusion on T-cell 17 (Th17)/regulatory T cells (Treg) and oxidative-antioxidant system in patients undergoing radical cervical cancer surgery. Methods A total of 80 patients who underwent radical cervical cancer surgery in Yan'an People's Hospital from October 2019 to October 2021 were selected as the study subjects and randomly divided into two groups: 40 cases in the control group, who received fentanyl with propofol target-controlled infusion; 40 cases in the experimental group, who received sufentanil with propofol target-controlled infusion. The levels of Th17/Treg-related indexes (Th17, Treg, Th17/Treg), oxidative-antioxidant system-related indexes[superoxide dismutase (SOD), malondialdehyde (MDA), catalase (CAT)] one hour before anesthesia, one hour after anesthesia and one hour after surgery., and pain level (VAS score) after surgery, six hours after surgery and 12 h after surgery were compared between two groups. Results The serum Treg levels in the two groups were significantly lower than those in the first hour after anesthesia and the first hour after surgery (P<0.05), and the serum Th17 and Th17/Treg levels in the two groups were significantly higher than those at one hour after anesthesia and one hour after surgery (P<0.05). Serum Treg levels were higher in the experimental group than in control group one hour after anesthesia and one hour after the end of surgery, and Th17 and Th17/Treg levels were lower than in control group (P<0.05). The levels of SOD, CAT and MDA in the two groups one hour after anesthesia and one hour after surgery were significantly higher than those one hour hour before anesthesia (P<0.05). Serum SOD and CAT levels were higher in experimental group than in control group one hour after anesthesia and one hour after the end of surgery, and MDA levels were lower than in control group (P<0.05). The VAS scores in experimental group were lower than those in control group at six hours and 12 h after surgery (P<0.05). Conclusion Compared with fentanyl combined with propofol target-controlled infusion, sufentanil combined with propofol target-controlled infusion in radical surgery for cervical cancer patients can reduce the effect on Th17/Treg and oxidative antioxidant system of patients and improve the analgesic effect.

R971

陜西省重點研發(fā)計劃項目(2018SF-432)