中文摘要：

目的：观察地佐辛静脉自控镇痛对肺叶切除术后免疫功能的影响。方法：选取60例拟行开胸肺叶切除术的患者随机分为对照组和DEZ组,每组30例。DEZ组术后PCA泵注0.5 mg·ml-1地佐辛,对照组术后PCA泵注0.9%氯化钠。采集患者麻醉诱导前（T0）、术后4 h（T1）、术后24 h（T2）和术后48 h（T3）血标本,测定血清CRP、TNF-α、IL-2、IL-6和IL-10水平,以及外周血淋巴细胞（L）计数及淋巴细胞中CD4＋T淋巴细胞、CD8＋T淋巴细胞、自然杀伤细胞（NK）比例的变化。于T1、T2和T3时点随访患者,记录患者视觉模拟评分（VAS）和数字镇静评分（NSS）。结果：肺叶切除术后患者血清CRP、TNF-α、IL-6和IL-10的水平较术前明显升高（P〈0.05）,IL-2较术前降低（P〈0.05）;术后外周血淋巴细胞计数及CD4＋T淋巴细胞比例和NK细胞比例较术前降低（P〈0.05）;地佐辛静脉自控镇痛能明显降低术后血清CRP、IL-6,升高IL-2及CD4＋T淋巴细胞比例（P〈0.05）;地佐辛组患者术后24 h的VAS评分低于对照组（P〈0.05）。结论：地佐辛静脉镇痛具有免疫调节作用,可改善肺叶切除术后的免疫抑制,并减轻炎症反应。

英文摘要：

OBJECTIVE To investigate effects of patient controlled analgesia（PCA）with intravenous dezocine on immune function in patients after pulmonary lobectomy.METHODS A total of 60 patients scheduled for pulmonary lobectomy were randomly enrolled in this study.Patients were assigned to control group（PCA with 0.9% sodium chloride,n=30）and DEZ group（PCA with 0.5 mg·ml-1 dezocine,n=30）.Serum C-reactive protein（CRP）,tumor necrosis factor-α（TNF-α）,interleukin-2（IL-2）,interleukin-6（IL-6）,and interleukin-10（IL-10）were determined before induction of anesthesia（T0）,4 h after operation（T1）,24 h after operation（T2）and 48 h after operation（T3）.Blood samples were also analyzed for total lymphocyte count,and percentages of CD4＋T cells,CD8＋T cells and natural killer（NK）T cells.Visual analogue scale（VAS）and numeric sedation scale（NSS）were recorded at T1,T2 and T3.RESULTS The serum CRP,TNF-α,IL-6 and IL-10 increased remarkably after operation（P〈0.05）,while IL-2 was decreased（P〈0.05）.Total lymphocyte count and percentages of CD4＋T cells and NK cells decreased after operation（P〈0.05）.The serum CRP and IL-6 were significantly lower in DEZ group after operation（P〈0.05）,while serum IL-2 and percentage of CD4＋T cells were higher in DEZ group（P〈0.05）.VAS at 24 h after operation was lower in DEZ group（P〈0.05）.CONCLUSION PCA with dezocine has notable immunoregulating effects,which can alleviate immunosupression and inflammation after pulmonary lobectomy.