Effects of different anesthesia methods on immune function, oxidative stress and related cytokine levels in elderly lung cancer patients undergoing radical operation

摘要

Objective: To investigate the effect of different anesthesia methods on immune function, oxidative stress and related cytokines in elderly patients undergoing radical mastectomy. Methods: The 90 elderly patients who underwent radical surgery for lung cancer from March 2016 to March 2018 were randomly divided into two groups, 45 cases each. One group was given sevoflurane inhalation anesthesia (sevoflurane group), and the other group was given propofol anesthesia (propofol group). The immune function, oxidative stress and related cytokine levels in immediately before induction of anesthesia (T0), 1 hour of surgery (T1), 2 hours of surgery(T2) and 2 hours after surgery (T3) were compared between the two groups. Result: At T1, T2 and T3, the levels of CD3+, CD4+ and CD4+/CD8+ in the two groups were significantly lower, and the levels of CD8+ were significantly higher those in T0 (P<0.05), and the levels of CD3+, CD4+ and CD4+/CD8+ in the sevoflurane group were significantly lower ,the level of CD8+ was significantly higher than those in the propofol group (P<0.05). There was no significant difference in VEGF and COX-2 levels between propofol groups at each time point (P>0.05), but at T3, VEGF and COX-2 levels in sevoflurane group were (415.12±60.23) pg/mL and (23.14±2.19) ng/mL respectively, which were significantly lower than those in T0 (P<0.05), and significantly lower than propofol group (P<0.05). There was no significant difference in MMP-2 and MMP-9 levels between propofol groups at each time point (P>0.05). The levels of MMP-2 and MMP-9 in the sevoflurane group at T2 and T3 were (324.83±26.81) ng/L, (352.05±31.96) ng/L, (313.19±27.32) ng/L and (345.21±33.04) ng/L respectively, which were significantly lower than those in T0, and significantly lower than propofol group (P<0.05). At T1 and T2, the MDA levels of the two groups were significantly higher than those in T0, and the SOD were significantly lower than those in T0 (P<0.05). At T2, the MDA level in the sevoflurane group was significantly lower than that in the propofol group (P<0.05), and the SOD level was significantly higher than that in the propofol group (P<0.05). Conclusion:Propofol intravenous anesthesia can protect the immune function of elderly patients undergoing radical lung cancer surgery, but sevoflurane can weaken the oxidative stress response and inhibit the expression of VEGF, COX-2, MMP-2 and MMP-9.