Effect of dexmedetomidine on Th1/Th2 cytokine and immune function in patients undergoing radical mastectomy

Objective: To investigate the effect of dexmedetomidine on Th1/Th2 cytokines and immune function in patients with breast cancer after radical mastectomy. Methods: In our hospital from July 2016 to July 2017 undergoing radical mastectomy for breast cancer were studied in 79 patients, were randomly divided into observation group and control group. Two groups of patients with routine preoperative preparation, monitoring blood pressure, electrocardiogram, heart rate, pulse, oxygen saturation, establish vein channel, using propofol, remifentanil, vecuronium induced anesthesia, observation group before induction of anesthesia, dexmedetomidine 1 μg/kg, 10 min after infusion, followed by 0.5 μg/kg/h continuous infusion to the end of the operation, the control group with normal saline continuous infusion till the end of the operation. Two groups of patients before induction of anesthesia (T 0 ), at the end of operation (T 1 ), 6 h after operation (T 2 ), 24 h after operation (T 3 ), 72 h after operation (T 4 ) from peripheral venous blood determination of interleukin-2 by ELISA method (IL-2), interleukin-4 (IL-4), interleukin-10 (IL-10) and interferon gamma (IFN-γ), calculated IFN-γ/IL-4 in T 0 , T 2 , T 3 , T 4 from peripheral blood. CD 3 + , CD 4 + , CD 8 + , NK cells were determined by flow cytometry and CD 4 + /CD 8 + were calculated. Results: Two groups of IL-2 and IFN- in T 1 , T 2 , T 3 gamma, T 4 is higher than T 0 , IL-10 less than T 0 , and the observation group IFN-γ/IL-4 is higher than T 0 , the control group was lower than that of T 0 when compared with T 0 significant difference, 2 in group IL-4 had no obvious changes were observed in group IL-2; IFN-γ, IFN-γ/IL-4 in T 1 , T 2 , T 3 , T 4 higher than the control group, IL-10 was lower than the control group, significant difference between the 2 groups. CD 3 + , CD 4 + , CD 4 + /CD 8 + , NK cells in T 2 group was lower than that of T 0 , T 3 , and CD 8 + had no obvious change, compared with T 0 significant difference; the observation group CD 3 + , CD 4 + , CD 4 + /CD 8 + , T 2 , T 3 in NK cells was higher than the control group, significant difference between the 2 groups. Conclusion: Dexmedetomidine can inhibit the stress response during the perioperative period of radical mastectomy, correct the balance disorder of Th1/Th2, improve the level of T lymphocyte subsets, and exert better immune protection function