脊髓胸段硬膜外麻醉对结直肠癌手术围术期中嗜中性粒细胞胞外俘获标志物的影响：一项随机对照试验。
Effect of Thoracic Epidural Anesthesia on Perioperative Neutrophil Extracellular Trapping Markers in Patients Undergoing Anesthesia and Surgery for Colorectal Cancer: A Randomized, Controlled Trial.
发表日期：2023 Aug 22
作者：
Han Wu, Shilai Wang, Hu Lv, Feifei Lou, Hua Yin, Yuechao Gu, Jun Zhang, Yajun Xu
来源：
ANNALS OF SURGICAL ONCOLOGY
摘要：
中性粒细胞外捕获（NETosis）是与结直肠癌转移风险增加密切相关的免疫机制。作者假设接受异丙酚硬膜外麻醉（PEA）的患者相对于接受全身麻醉（GA）的患者，血清中性粒细胞过氧化物酶（MPO）和柠檬酸化组蛋白H3（H3Cit）表达水平会降低。对结直肠癌手术患者进行随机分组，分为PEA组（n = 30）和GA组（n = 30）。测量术前和术后24小时的血清MPO、H3Cit和金属蛋白酶-9（MMP-9）水平，并记录视觉模拟评分（VAS）。接受PEA的患者在术后24小时与接受GA的患者相比，MPO（28.06 ± 11.23 vs 20.54 ± 7.29 ng/ml；P = 0.004）和H3Cit（3.22 ± 0.86 vs 2.73 ± 0.94 ng/ml；P = 0.042）水平较低。此外，MMP-9水平没有差异（75.98 ± 26.9 vs 73.45 ± 28.4 ng/ml；P = 0.726）。PEA组术后2小时和24小时的视觉模拟评分明显较低（P < 0.05）。术后48小时内，PEA组术后镇痛泵按压次数和舒芬太尼消耗明显较低（P < 0.001）。异丙酚硬膜外麻醉能够降低结直肠癌手术期间血清中性粒细胞外捕获（MPO和H3Cit）的表达。ChiCTR2200066708 (www.chictr.org.cn)。© 2023年外科肿瘤学会。
Neutrophil extracellular trapping (NETosis) is an immunologic mechanism strongly linked with increased metastatic risk in colorectal cancer. The authors hypothesized that patients who received propofol-epidural anesthesia (PEA) would exhibit decreases in the expression of serum neutrophil myeloperoxidase (MPO) and citrullinated histone H3 (H3Cit) levels compared with patients who received general anesthesia (GA).Colorectal cancer surgery patients were randomly assigned to the PEA (n = 30) or GA (n = 30) group. Serum MPO, H3Cit, and metalloproteinase-9 (MMP-9) levels before surgery and 24 h after surgery were measured, and visual analogue scale (VAS) scores were recorded.The patients who received PEA showed decreases in MPO (28.06 ± 11.23 vs 20.54 ± 7.29 ng/ ml; P = 0.004) and H3Cit [3.22 ± 0.86 vs 2.73 ± 0.94 ng/ ml; P = 0.042) 24 h after surgery compared with the patients subjected to GA. In addition, there was no difference in MMP-9 levels (75.98 ± 26.9 vs 73.45 ± 28.4 ng/ ml; P = 0.726). The visual analogue scale scores 2 h and 24 h after operation were significantly lower in PEA group (P < 0.05). The number of postoperative analgesia pump pressings and sufentanil consumptions within 48 h after surgery were significantly lower in the PEA group (P < 0.001).Propofol-epidural anesthesia reduces the expression of NETosis (MPO and H3Cit) in serum during colorectal cancer surgery.ChiCTR2200066708 ( www.chictr.org.cn ).© 2023. Society of Surgical Oncology.