| Objective: To investigate the Inhalation anesthesia of sevflurane or isoflurane on the changes of T-lymphocyte subsets,tumor necrosis - a (TNF -α) , interleukine - 6 ( IL - 6) , Soluble IL-2 receptor (sIL-2R)and antigen presenting function of dendritic cells(DCs) of the patients undergoing lobectomy for colorectal cancer during perioperative, and to propose the best project of anesthesia for patients with cancerMethods: thirty ASAI-II patients aged 45 to 65yr, TNM I~II ,weighting 50-77kg (16 male, 14 female) undergoing radical surgery for rectal cancer were randomly divided into 2 groups: group sevflurane (SEV n=15), group isoflurane (ISO n=15). Patients were premedicated with intramuscular atropine 0.01 mg/kg midazolam 0.05 mg/kg at half a hour before surgery, Two patients were intravenous fentany0.05ug/kg,propofol 2 mg/kg, and intravenous vecuronium 0.15 mg/kg for the induction of anesthesia. Mechanical ventilation by anesthesia machine after cannulaing,group Sev inhaled 1~2% sevoflurane, group ISO inhaled 1~1.5% isoflurane to maintain Anesthesia both of two group were infused with target-controlled of remifentanil 1.6ng/ kg , to keep BIS 40~60. Venous blood samples were collected at time before anesthesia(T0),1h after the beginning of operation (T1), after termination of operation (T2), 24h after the end of operation (T3), 72h after the end of operation. (T4) for determination of the expression of CD3+,CD4+,CD8+ T-lymphocyte and concentration of interleukin-6 (IL-6) and soluble Interleukin-2 (SIL-2R), a tumor necrosis factor (TNF-a) in blood serum .cytokine radiation are measured by enzyme- linked immunosorbent assay (ELISA) measurements.Results:1 the change of percentage CD3+,CD4+,CD8+T- lymphocyte subsets of two groups.there was no significant difference in T lymphocyte subsets indicators in two group at T0 points (P> 0.05), CD3+ % of group ISO showed significantily decrease at T1 points(P<0.05).CD4+,CD8+ % not more significantily at T1 change than that of T0(P>0.05) more of the remaining time no significant different in two groups(P>0.05).comparison between two groups: CD3+ in ISO was heighter than that in group SEV(P<0.05)。2 the serum of IL-6 of two groupsIL-6 in both groups increase significantly at T1 points T2 than That of T0(P<0.05),then serum IL-6 levels gradually dropped to the preoperative level fromT3 and T4 points.comparison between two groups: the serum of IL-6 in group SEV was lower than that in group SEV at T2 points(P<0.05). 3 the serum of TNF-αof two groupsthe serum TNF-a was no different between T1 points and T0 points(P>0.05). At T3 points and T4 points it was higher than that of T0(P<0.05).comparison between two groups: the serum TNF-a in groud SEV was higher than that in group ISO at T4 points (P<0.05).4 the serum of sIL-2R of two groupsthe change of the serum sIL-2R levels in group ISO and SEV was no different at the time of T0,T1,T2(P>0.05)。sIL-2R was no more different at T3 points than that T0 points(P>0.05) It was lower at T4 points in two groups than that at T0 points (P<0.05).comparison between two groups: In group SEV the serum SIL-2R was higher than that in group ISO at the end of operation and the 24h postoperation(P>0.05)。it declined to the level of T0 at T4.5 the change of dentrinic cell costimulatory molecules CD80/86.comparison in groups the CD80 level was lower at T2 and T3 than that of T0(P<0.05). CD86 level was higher at T2 T3 than T0 (P<0.05).comparsion between two groups: the CD86 level of group iso was lower than that in group SEV atT2 and T3(P<0.05).Conclusion :1 Sevoflurane not effection on T-lymphocyte subsets suppression of isoflurane on the T-lymphocyte is selective and temporary, most of the targets was resume 24h and 72 h after surgery.2 Sevoflurane was better than isoflurane to inhibit serum cytokine IL-6,TNF-a and sIL-2Rof patients undergoing radical surgery for rectal cancer.Sevoflurane has positive significance on tumor patient's immune function recovery.3 Sevoflurane and isoflurane may have inhibition on the expression of CD80 molecules. The CD86 expressed on DCs wer similar in both groups.4 the effection of Sevoflurane is samller at the level of cell ane cytokines than that of Isoflurane and has positive significance on immune cells of patients with cancer. |
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