丙泊酚麻醉对肝癌射频消融术患者血清白介素和HSP70水平的影响

摘要

目的:探讨丙泊酚全身麻醉对肝癌射频消融术患者血清白介素(IL)-6、8、10和热休克蛋白70(HSP70)水平的影响.方法:择期行肝癌射频消融术的患者40例,分成2组施术,每组20例.观察组患者在全麻诱导后应用丙泊酚和瑞芬太尼维持麻醉,对照组患者在穿刺部位利多卡因局部阻滞麻醉.术中检测麻醉前、首次穿刺成功时,热封闭针道时,术后1 h、24 h和48 h时的平均血压、心率、脉搏血氧饱和度和体温;采集患者术前,术后1、24和48 h静脉血5 mL,ELISA法测定血清IL-6、IL-10、IL-8及HSP70.结果:2组患者术中和术后体温、血压均升高,但观察组变化幅度小于对照组(体温:F组间=14.568,F时间=291.525,F交互=13.655,P均<0.001;血压:F组间=23.372,F时间=14.007,F交互=25.795,P均<0.001).2组术后血清IL-6、8、10及HSP70水平亦较术前升高(F时间分别为48.793、53.721、25.970和24.779,P均<0.001),而观察组L-6、8和HSP70升高幅度小于对照组(F组间=31.953、59.836和20.479,P均<0.001).结论:丙泊酚麻醉可减轻肝癌射频消融术患者的伤害性炎性反应.%Aim;To study the effects of propofol anesthesia on serum interleukins (IL) and HSP70 levels in patients with liver cancer after radiofrequency ablation ( RFA). Methods:Forty ASA I-Ⅱ patients with liver cancer aged 40 ~65 years would receive RFA were divided into 2 groups (20 in each group). Patients in group P were given propofol to maintain general anesthesia. Patients in group C were given lidocaine to maintain local anesthesia . MBP, HR, SPO2, and temperature were detected at the time of pre -anesthesia , post-anesthesia, heat blocking action , and 1,24 and 48 h after therapy. In addition , serum IL-6, IL-8, IL-10 and HSP70 levels were determined before therapy and at 1,24, and 48 h after therapy by ELISA. Results: The temperature , MBP, and serum HSP70, IL-6, IL-8 , IL-10 levels of the two groups increased during RFA (Ftime =291.525,14.007,24.779,48.793,53.721,and25.970,P<0.001), but the changes of group C was more obvi-ous than group P (P < 0. 001). Conclusion: Propofol anesthesia can effectively restrain the damaged inflammatory reaction in patients with liver cancer after RFA.