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| 七氟醚复合右美托咪定对HIV无症状感染者术后免疫系统的影响 |
| Effect of sevoflurane combined with dexmedetomidine on immune system after surgery in patients with asymptomatic human immunodeficiency virus infection |
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| DOI：10.12089/jca.2018.11.007 |
| 中文关键词: 七氟醚 右美托咪定 人类免疫缺陷病毒 无症状感染期 免疫功能 |
| 英文关键词: Sevoflurane Dexmedetomidine Human immunodeficiency virus Asymptomatic infection Immune function |
| 基金项目: |
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| 中文摘要: |
目的 研究七氟醚复合右美托咪定对人类免疫缺陷病毒(human immunodeficiency,HIV)无症状感染者手术后免疫系统的影响。
方法 选择在本院接受胆囊切除术、妇科良性肿瘤切除术以及结肠良性肿瘤切除术的HIV无症状感染者60例,男28例,女32例,年龄35～51岁,体重58～62 kg,ASA Ⅰ—Ⅲ级,随机分为3组:七氟醚组(S组)、右美托咪定(D组)和七氟醚复合右美托咪定组(SD组),每组20例。同时选择20例行全麻下胆囊切除术、妇科良性肿瘤切除术以及结肠良性肿瘤切除术的正常患者为对照组(N组)。测定患者手术前和手术后24 h外周血血常规(白细胞、中性粒细胞、淋巴细胞、单核细胞)、T淋巴细胞亚群(CD3+、CD4+、CD8+)和HIV病毒载量。
结果 与手术前比较,手术后24 h S组和D组外周血淋巴细胞、CD4+含量、CD4+/CD8+比值明显降低,中性粒细胞、单核细胞、CD8+含量明显升高(P<0.05)。与N组比较,术后24 h SD组CD4+含量、CD4+/CD8+比值明显降低,CD8+含量明显升高(P<0.05)。与S组比较,SD组术后外周血CD8+含量明显下降,CD4+/CD8+比值明显升高(P<0.05)。S组、D组和SD组术前术后病毒载量构成比差异无统计学意义。
结论 七氟醚复合右美托咪定麻醉可能减轻全麻手术对HIV无症状感染期患者免疫系统的影响。 |
| 英文摘要: |
Objective To study the effect of sevoflurane combined with dexmedetomidine on immune system after surgery in patients with asymptomatic human immunodeficiency virus (HIV) infection.
Methods Sixty patients with asymptomatic acquired imunedeficiency syndrome (AIDS) who underwent cholecystectomy, gynecologic benign tumor resection, and benign colon tumor resection were enrolled in this hospital. There were 28 males and 32 females, aged 35 - 51 years old, weighing 58 - 62 kg, falling into ASA physical status Ⅰ - Ⅲ. In Public Health Medical Center were selected and randomly divided into control group (group N), sevoflurane group (group S), dexmedetomidine group (group D) and sevoflurane combined with dexmedetomidine group (group SD). At the same time, twenty patients undergoing general anesthesia were selected as control group (group N), who underwent cholecystectomy, gynecologic benign tumor resection and benign colon tumor resection in the hospital. Blood routine indexes, T lymphocyte subsets and plasma viral load were observed 24 h after operation.
Results The gender, age, body weight and operation time had no significant difference among the three groups. The levels of CD4+, CD4+/CD8+in peripheral blood of the patients in group S and group D 24 h after operation were significantly lower, the levels of neutrophils, monocytes and CD8+ were significantly higher (P<0.05). Compared with the group N, CD4+ and CD4+/CD8+ ratios of the group SD were decreased 24 h after surgery (P<0.05), and the CD8+ content was significantly increased (P<0.05). Compared with group S, group SD CD8+ decreased and the ratio of CD4+/CD8+ increased, the difference was statistically significant (P<0.05). There was no significant difference in each index of group SD after operation. There was no significant difference in the composition ratio of viral load between groups S, D and SD after operation.
Conclusion Sevoflurane combined with dexmedetomidine anesthesia may reduce the impact of surgery on the immune system of patients with asymptomatic HIV infection. |
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