Effects of different doses of dexmedetomidine on inflammatory factors and T lymphocyte subsets in elderly patients undergoing laparoscopic surgery

摘要

Objective:To investigate the effects of different doses of dexmedetomidine on inflammatory factors and T lymphocyte subsets in elderly patients undergoing laparoscopic surgery. Methods: from June 2016 to June 2017 in our hospital for laparoscopic surgery of 120 cases of elderly patients, were randomly divided into A group, B group, C group, D group of 30 cases, all patients underwent intravenous inhalational anesthesia, A, B, C in three groups were given dexmedetomidine before induction of anesthesia. Fixed loading dose of 0.5 μg/kg, after intubation respectively with dexmedetomidine 0.2 μg/(kg.h), 0.5 μg/(kg.h), 0.8 μg/(kg.h) after continuous infusion to surgery, D group at the same time with the same volume of physiological saline. Before induction of anesthesia (T0), 24 h after operation (T1), 72 h after operation (T2) of venous blood interleukin-1 were measured beta (IL-1 beta), interleukin -2 receptor (sIL-2R) and interleukin-6 (IL-6), tumor necrosis factor alpha (TNF-alpha) and T lymphocyte subsets (CD3+, CD4+, D8+).Results: the T1 of the 4 groups of sIL-2R, IL-6, IL-1 beta, TNF-alpha and T0 levels were significantly higher than, and A group, B group and C group than in D group, B group and C group than in A group, B group and C group had no significant difference;group IL-1, sIL-2R, IL-6, TNF-beta and alpha level of T1 decreased significantly, and A group, B group and C group than in D group, B group and C group than in A group, B group and C group had no significant difference. T1 of the 4 groups of CD3+, CD4+, D8+, CD4+/CD8+ and T0 decreased significantly, and A group, B group and C group than in D group, B group and C group than in A group, B group and C group had no significant difference;T2 D group CD3+, CD4+, D8+, CD4+/CD8+ lower than T1, and A group, B group, C group, CD3+, CD4+, D8+, CD4+/CD8+ higher than that of D group, B group, C group, CD3+ CD4+, D8+, CD4+/CD8+ higher than that of A group, B group, C group no significant difference.Conclusion: Dexmedetomidine can inhibit the inflammatory reaction and improve the immune function in elderly patients undergoing laparoscopic surgery, and the effect of middle and high dose is more significant.