七氟烷联合丙泊酚-瑞芬太尼静吸复合全麻对儿童经纤维支气管镜异物取出术后Ｔ淋巴细胞亚群的影响*

Effect of static suction compound general hemp Sevoflurane combined with Propofol-Remifentanil on T lymphocyte subsets after removal of foreign body in children undergoing bronchoscopy*

摘要:

探讨静吸复合全麻对儿童经纤维支气管镜异物取出术后外周血T辅助细胞亚群变化的影响。方法 选择2016年6月－2018年6月该院支气管镜下异物取出术患儿，其中采用局麻的15例为观察组1，采用静吸复合全麻患儿15例为观察组2，对照组15例为同期行喉镜检查的健康儿童，比较3组外周血T淋巴细胞亚群的表达水平。结果 3组支气管镜术后血液CD4+T淋巴细胞亚群比较，差异有统计学意义（F =50.34，P =0.001），而CD8+T淋巴细胞亚群无明显差异（F =2.27，P =0.184），CD4+/CD8+则有明显差异（F =147.83，P =0.000）；3组中两两比较，观察组2 CD4+T淋巴细胞明显低于对照组和观察组1（t =9.74，P =0.000；t =7.04，P =0.001）；而观察组2 CD4+/CD8+明显低于对照组和观察组1（t =15.64，P =0.000；t =10.57，P =0.000）；3组支气管镜术后血液干扰素-γ（IFN-γ）水平比较，差异无统计学意义（F =2.36，P =0.172），白细胞介素-4（IL-4）水平有明显差异（F =9.32，P =0.001），IFN-γ/IL-4也有明显差异（F =4.52，P =0.023），3组两两比较，观察组2血清IL-4水平明显低于对照组和观察组1（t =3.42，P =0.001；t =3.96，P =0.001）；IFN-γ/IL-4两两比较，观察组2明显高于对照组和观察组1（t =2.64，P =0.025；t =2.67，P =0.025）。结论 静吸复合全麻可能有一过性抑制CD4+T淋巴细胞亚群的作用。

Abstract:

To study the effect of compound intravenous anesthesia on T lymphocyte subsets after removal of foreign body in children undergoing bronchoscopy. Methods Children who underwent bronchial foreign body removal from June 2016 to June 2018 were selected. Among them, 15 cases who treated with local anesthesia were selected as observation group 1, 15 cases of healthy children who treated with static suction compound general hemp were selected as observation group 2, and 15 cases who underwent laryngoscopy were selected as control group, then the expression of T lymphocyte subsets in the peripheral blood was compared among the 3 groups. Results There were significant differences in CD4+T lymphocyte subsets among 3 groups after bronchoscopy (F = 50.34, P = 0.001); while there was no significant difference in CD8+T lymphocyte subsets (F = 2.27, P = 0.184);Then the CD4+T lymphocyte was compared with each other, which in observation group 2 was significantly lower than in the control group and in the observation group 1 (t = 9.74, P = 0.000; t = 7.04, P = 0.001). The CD4+/CD8+ in observation group 2 was significantly lower than in the control group and in the observation group 1 (t = 15.64, P = 0.000; t = 10.57, P = 0.000). There was no significant difference in the level of IFN-γ in blood among the 3 groups after bronchoscopy (F = 2.36; P = 0.172). While there was significant difference in the level of IL-4 (F = 9.32, P = 0.001). And there was also significant difference in IFN-γ/IL-4 (F = 4.52, P = 0.023). The level of IL-4 in blood was compared each other, which in the observation group 2 was significantly lower than that in the control group and the observation group 1 (t = 3.42, P = 0.001; t = 3.96, P = 0.001), and also IFN-γ and /IL-4 was compared each other, which in the observation group 2 was significantly higher than that in the control group and the observation group 1 (t = 2.64, P = 0.025; t = 2.67, P = 0.025). Conclusion Static suction compound general hemp may have a transient suppression of CD4+T lymphocyte subsets.