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目的:探讨黄芪注射液对腹腔镜手术患者围术期T淋巴细胞免疫功能的影响。方法:40例择期全麻下行腹腔镜手术的不孕症患者,随机分成黄芪注射液组和对照组。注射组静滴黄芪注射液10 ml+生理盐水90 ml,15 min滴完后静注芬太尼、丙泊酚、顺式阿曲库铵行气管插管控制呼吸,术中以丙泊酚及七氟醚维持麻醉,维持生命体征在正常水平,术毕前腹腔冲洗液加入黄芪注射液10 ml。对照组静滴生理盐水100 ml后麻醉,腹腔冲洗液中不加黄芪注射液,余同注射组。采集手术前(T0)、术毕(T1)、术后1天(T2)、术后3天(T3)的静脉血,流式细胞仪测定T淋巴细胞亚群(CD3+、CD4+、CD8+)的水平,计算CD4+/CD8+比值。结果:与T0时比较,对照组CD3+、CD4+水平及CD4+/CD8+比值在T1、T2时均明显下降,T3时才基本恢复T0时水平,注射组上述指标在T1时下降,但T2时已恢复T0时水平,两组CD8+水平在T1、T2、T3时均无明显变化;组间比较,T2、T3时两组CD3+、CD4+水平及CD4+/CD8+比值均有统计学差异,注射组高于对照组,CD8+水平两组间无统计学差异。结论:对照组术后T淋巴细胞亚群水平相对注射组明显下降,表明黄芪注射液在腹腔镜手术的应用对T淋巴细胞的免疫功能具有一定的保护作用。
Objective: To investigate the effect of Astragalus injection on immune function of T lymphocytes in patients undergoing laparoscopic surgery. Methods: Forty patients with infertility undergoing laparoscopic surgery under general anesthesia were randomly divided into astragalus injection group and control group. Intravenous injection of Astragalus injection 10 ml + saline 90 ml, intravenous injection of fentanyl, propofol 15 minutes after intravenous infusion of atracurium endotracheal intubation controlled breathing, intraoperative propofol and seven Fluoride ether to maintain anesthesia, maintain vital signs at normal levels, before surgery peritoneal rinse added astragalus injection 10 ml. In the control group, 100 ml normal saline was anesthetized, and Astragalus injection was not added to the peritoneal wash fluid. Blood samples of T lymphocyte subsets (CD3 +, CD4 +, CD8 +) were collected before operation (T0), at the end of operation (T1), 1 day after operation (T2) and 3 days after operation Level, calculate the ratio of CD4 + / CD8 +. Results: Compared with T0, the ratio of CD3 +, CD4 + and CD4 + / CD8 + in control group decreased significantly at T1 and T2, but recovered to T0 level at T3, while the index in injection group decreased at T1 but recovered at T2 There was no significant difference in the level of CD8 + between the two groups at T1, T2 and T3. There were significant differences in the levels of CD3 +, CD4 + and CD4 + / CD8 between the two groups at T2 and T3, There was no significant difference between the two groups on CD8 + level. Conclusion: The level of T lymphocyte subsets in the control group decreased significantly compared with the injected group, indicating that the application of Astragalus injection in laparoscopic surgery has a protective effect on the immune function of T lymphocytes.