Effect of dexmedetomidine on Th1/Th2 cytokine and immune function in patients undergoing radical mastectomy

摘要

Objective: To investigate the effect of dexmedetomidine on Th1/Th2 cytokines and immune function in patients with breast cancer after radical mastectomy. Methods: In our hospital from July 2016 to July 2017 undergoing radical mastectomy for breast cancer were studied in 79 patients, were randomly divided into observation group and control group. Two groups of patients with routine preoperative preparation, monitoring blood pressure, electrocardiogram, heart rate, pulse, oxygen saturation, establish vein channel, using propofol, remifentanil, vecuronium induced anesthesia, observation group before induction of anesthesia, dexmedetomidine 1 μg/kg, 10 min after infusion, followed by 0.5 μg/kg/h continuous infusion to the end of the operation, the control group with normal saline continuous infusion till the end of the operation. Two groups of patients before induction of anesthesia (T0), at the end of operation (T1), 6 h after operation (T2), 24 h after operation (T3), 72 h after operation (T4) from peripheral venous blood determination of interleukin-2 by ELISA method (IL-2), interleukin-4 (IL-4), interleukin-10 (IL-10) and interferon gamma (IFN-γ), calculated IFN-γ/IL-4 in T0, T2, T3, T4from peripheral blood. CD3+, CD4+, CD8+, NK cells were determined by flow cytometry and CD4+/CD8+ were calculated. Results: Two groups of IL-2 and IFN- in T1, T2, T3gamma, T4is higher than T0, IL-10 less than T0, and the observation group IFN-γ/IL-4 is higher than T0, the control group was lower than that of T0when compared with T0significant difference, 2 in group IL-4 had no obvious changes were observed in group IL-2;IFN-γ, IFN-γ/IL-4 in T1, T2, T3, T4higher than the control group, IL-10 was lower than the control group, significant difference between the 2 groups. CD3+, CD4+, CD4+/CD8+, NK cells in T2group was lower than that of T0, T3, and CD8+ had no obvious change, compared with T0significant difference;the observation group CD3+, CD4+, CD4+/CD8+, T2, T3in NK cells was higher than the control group, significant difference between the 2 groups. Conclusion: Dexmedetomidine can inhibit the stress response during the perioperative period of radical mastectomy, correct the balance disorder of Th1/Th2, improve the level of T lymphocyte subsets, and exert better immune protection function.