目的:探讨丙泊酚联合瑞芬太尼对肝癌切除术患者凋亡分子和血浆C-X-C基序趋化因子配体10(CXCL10)、C-X-C基序趋化因子配体13(CXCL13)的影响。方法:采用随机数字表法将125例肝癌切除术患者分为对照组(丙泊酚联合芬太尼维持麻醉，62例)和研究组(丙泊酚联合瑞芬太尼维持麻醉，63例)。对比两组术后苏醒效果、Ramsay镇静评分、视觉模拟量表(VAS)评分、凋亡分子、血浆CXCL10、CXCL13。结果:相较于对照组，研究组的呼之睁眼时间、拔管时间、自主呼吸恢复时间均更短(P＜0。05)。术后6h、术后12 h两组Ramsay镇静评分下降，VAS评分升高，但研究组术后6 h、术后12 h Ramsay镇静评分高于对照组，VAS评分低于对照组(P＜0。05)。研究组术后1 d血浆B淋巴细胞瘤-2基因(Bcl-2)、存活素(Survivin)低于对照组，血浆半胱氨酸天冬氨酸蛋白酶-4(Caspase-4)、B淋巴细胞瘤-2相关X蛋白(Bax)高于对照组(P＜0。05)。术后1 d，两组血浆CXCL10和CXCL13水平下降，且研究组术后1 d血浆CXCL10和CXCL13水平低于对照组(P＜0。05)。结论:丙泊酚联合瑞芬太尼用于肝癌切除术患者，具有良好的镇静镇痛效果，可有效控制凋亡分子和血浆CXCL 10、CXCL13水平，提高患者术后苏醒效果。
Effects of Propofol Combined with Remifentanil on Apoptosis Molecules and Plasma CXCL10 and CXCL13 in Patients Undergoing Liver Cancer Resection
Objective:To investigate the effects of propofol combined with remifentanil on apoptosis molecules and plasma C-X-C motif ligand(CXCL)10 and CXCL13 in patients undergoing liver cancer resection.Methods:According to the random number table method,125 patients were divided into control group(propofol combine with fentanyfol maintained anesthesia,62 cases)and study group(propofol combine with remifentanil anesthesia,63 cases).Postoperative awakening effect,Ramsay calmness score,visual analog scale(VAS)score,apoptotic molecules,plasma CXCL10 and CXCL13 were compared between two groups.Results:Compared with control group,study group had a shorter time to open eyes on exhalation,time to extubation and time to recover from spontaneous respi-ration(P＜0.05).Ramsay calmness score decreased and VAS score increased in two groups 6 h after operation and 12 h after operation,and Ramsay calmness score was higher and VAS score was lower in study group than in control group 6 h after operation and 12 h after operation(P＜0.05).1 d plasma B postoperative lymphocytoma-2 gene(Bcl-2)and survivin(Survivin)in study group were lower than that in control group,and plasma cysteine aspartate protease-4(Caspase-4)and B lymphocytoma-2 related X protein(Bax)were higher than that in control group(P＜0.05).1 d after operation,plasma CXCL10 and CXCL13 levels decreased in two groups,and plasma CXCL10 and CXCL13 levels were lower in study group than in control group 1d after operation(P＜0.05).Conclusion:Propofol combined with remifentanil has a good sedative and analgesic effect in patients undergoing liver cancer resection,which can effectively control the levels of apoptotic molecules and plasma CXCL10 and CXCL13,and improve the postoperative recovery effect of patients.
PropofolRemifentanilLiver cancer resectionApoptosis moleculesCXCL10CXCL13
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