【摘要】 目的 比较异丙酚和依托咪酯乳剂-宜妥利两种静脉全麻诱导药对重型创伤患者围术期T细胞免疫功能的影响。方法 急诊重型创伤患者20例按全麻诱导用药不同分两组：异丙酚组(P组)，宜妥利组(E组)。分别于全麻诱导前(T0)、诱导后5min(T1)、术毕(T2)、术后1天(T3)和术后3天(T4)检测CD3+ T淋巴细胞及亚群(CD4+、CD8+)水平。结果 两组患者的CD3+、CD4+、CD4+/CD8+术毕与诱导前相比下降明显，术后1天CD3+开始回升恢复正常，CD4+、CD4+/CD8+术后1天、术后3天逐渐上升，但均未恢复正常，在相同时间点两组间T淋巴细胞及其亚群差异均无显著性。结论 在诱导剂量范围内，异丙酚和宜妥利对重型创伤患者的T细胞免疫功能影响无明显差异。

    【关键词】 T淋巴细胞亚群；全身麻醉；依托咪酯；二异丙酚

    Different changes between T-lymphocyte subsets in severe traumatic patients after induction

    CAO Yu-qi,CHEN Wu-rong,ZHANG Jie.Department of Anesthesiology, Putuo Hospital Affiliated to Shanghai Chinese Traditional Medical University,Shanghai 200062,China

    【Abstract】 Objective To compare the different changes between T-lymphocyte and immune factors in severe traumatic patients after induction.Methods Twenty severe traumatic patients undergoing emergency surgery were divided into two groups according to different general anesthetics received:Group P receiving propofol and Group E receiving etomidate.The plasma level of CD3+,CD4+,CD4+/CD8+ were detected and compared between the two groups at the time point of:before induction (T0),5 min after induction (T1),the end of surgery (T2),1 day after surgery (T3) and 3 day after surgery (T4).Results The level of CD3+,CD4+,CD4+/CD8+ were significantly decreased at the end of surgery.At the same time point, the level of the T-lymphocyte subsets were of no difference between the two groups.Conclusion At the induction dosage, the effects of propofol and etomidate on the T-lymphocyte subsets of severe traumatic patients had no significant difference. ......