Effect of dexmedetomidine on stress response and cellular immune function in patients undergoing radical resection of colon cancer / 中国免疫学杂志

ABSTRACT

Objective:To investigate the effect of dexmedetomidine on stress response and cellular immune function in patients undergoing radical resection of colon cancer during perioperative period.Methods: 96 cases of colon cancer undergoing radical resection were randomly divided into dexmedetomidine group(group D)and control group(group C).The group D was intubated with in-travenous infusion of dexmedetomidine 0.6 μg/kg,followed by intravenous infusion of 0.3 μg/(kg·h) at the end of the surgery,and the group C was given 0.9% saline at equal volume and rate.The venous blood of patients was collected before anesthesia induction,10 min(T0),immediate postoperative(T1),postoperative 24 h(T2)and postoperative 72 h(T3).Flow cytometry were used to detect T lym-phocyte subsets(CD3+,CD4+,CD8+,CD4+/CD8+)and the percentage of NK cells,and determination of norepinephrine(NE), epinephrine(E),cortisol(Cor),IL-6,IL-10 and TNF-α levels.Records of patients with T0,immediate intubation(Ta),T1,immediate extubation(Tb)of SBP,DBP,MAP,and postoperative adverse reactions were recorded.Results:The SBP,DBP and MAP of group C at Ta,T1,Tbwere significantly higher than that of T0and group D(P<0.05).Compared to those at T0,the levels of CD3+,CD4+,CD8+and CD4+/CD8 at T1and T2were significantly lower in both groups(P<0.05),and the levels of group C at T1,T2,T3were significantly lower than those in group D(P<0.05).The NK cells of group C at T1,T2were significantly lower than that of T0and group D(P<0.05).Compared to those at T0,the levels of IL-6,IL-10 and TNF-α at T1and T2were significantly higher in both groups(P<0.05), and the levels in group C were significantly higher than those in group D(P<0.05).The IL-6 and IL-10 of group C at T3were significantly higher than that of T0and group D(P<0.05).Compared to those at T0,the levels of NE,E and Cor at T1and T2were sig-nificantly higher in both groups(P<0.05),and the levels in group C were significantly higher than those in group D(P<0.05).The NE,E and Cor of group C at T3were significantly higher than that of T0and group D(P<0.05).The proportion of adverse reactions in group D was significantly lower than that in group C(χ2= 4.800,P= 0.028).Conclusion: Dexmedetomidine can inhibit the perioperative stress response and reduce the impact on immune function in patients undergoing radical resection of colon cancer.