论文部分内容阅读
目的比较老年直肠癌患者术中轻度低温及正常体温下细胞因子IL-2、IL-10的变化与术后早期认知功能的变化是否具有相关性.方法 ASAⅠ-Ⅱ级拟行直肠癌手术老年患者40例,年龄65~83岁,随机均分为常温组(Ⅰ组)和轻度低温组(Ⅱ组).分别于麻醉前1 h(T1)、手术结束时(T2)及术后24 h(T3)用流式细胞仪检测细胞因子IL-2、IL-10;另于术前1 d(N1)、术后第1天(N2)及术后第3天(N3)用MMSE量表对患者进行神经精神功能测试并记录得分情况.结果与T1时比较,II组IL-2血浆浓度在T2、T3时明显降低(P<0.01);与T1、T2时比较,II组T3时IL-10浓度明显增高(P<0.01).与N1时比较,2组患者MMSE评分N2时下降(P<0.05),尤以Ⅱ组降低明显,组间比较有差异(P<0.05).N3时评分又逐渐升高,与N2比较有差异(P<0.05).T2、T3时II组IL-2与N2时的MMSE评分存在明显的正相关性(r=0.459,P<0.01)(r=0.550,P<0.01).结论术中轻度低温导致的IL-2降低与老年直肠癌患者术后早期MMSE评分降低存在正相关.
Objective To compare the changes of cytokines IL-2 and IL-10 with the changes of early postoperative cognitive function in elderly patients with rectal cancer under mild hypothermia and normal body temperature.Methods ASAⅠ-Ⅱ patients underwent rectal cancer surgery Forty elderly patients aged 65-83 years were randomly divided into normal temperature group (group Ⅰ) and mild hypothermia group (group Ⅱ) .At the time of 1 h (T1), the end of operation (T2) The levels of cytokines IL-2 and IL-10 were detected by flow cytometry at 24 h (T3). The rats were sacrificed on day 1 (N1), day 1 (N2) and day 3 The patients were tested for neuropsychiatric function and score was recorded.Results Compared with T1, the concentration of IL-2 in group II was significantly decreased at T2 and T3 (P <0.01); Compared with T1 and T2, (P <0.01) .Compared with N1, MMSE score of two groups decreased at N2 (P <0.05), especially in group Ⅱ decreased significantly (P <0.05). (P <0.05) .There was a significant positive correlation between MMSE score of IL-2 and N2 at T2 and T3 (r = 0.459, P <0.01) (P <0.05) r = 0.550, P <0.01) .Conclusion The decrease of IL-2 caused by mild hypothermia during operation is similar to that of old age Early postoperative MMSE score was positively correlated reduce the presence of cancer.