Effects Of Different Colloids Infusion During Surgery On Immunologic Function In Patients With Esophageal Carcinoma Post-surgery

Objective:To observe the effects of different colloids ( Hydroxyethyl Starch Injection, HES; Polygeline Injection, PG) and Ringer's solution on T lymphocytes and T cell subgroup, IL-6, IL-2 and TNF-a in patients after esophageal carcinoma surgery.Methods:Fifty-one ASAⅠ-Ⅱpatients with esophageal carcinoma (male 37, female 14) were randomly assigned to three groups, 17 patients in each group. Hydroxyethyl Starch Injection (group H), Polygeline Injection (group P) and Ringer's solution (group L) were infused by 33ml/kg during surgery respectively in each group. The blood samples were collected before anesthesia (d0) and on the first day (d1), 3rd day (d3), 7th day (d7) after operation. Flow cytometry was used to measure the amounts of T lymphocyte and T cell subgroup. ELISA was used to determine the contents of IL-6, IL-2, TNF-a.Results:No significant differences were found in all measurement indicators among the 3 groups on d0(P>0.05).The counts of CD3,CD4 descended markedly on d1(P﹤0.01) in all groups, and went up on d3, but were still lower than those on d0(P﹤0.01), and restored to normal on d7. The count of CD4 in group P was lower than that in group L on d1(P﹤0.05). The counts of CD3,CD4 in group H and group P were higher than those in group L on d3(P﹤0.05). The counts of CD8, CD4/CD8 were no significantly differences in each group(P>0.05). The count of IL-2 ascended in group H, and had statistical difference compared with group L on d1,d3 and d7 (P﹤0.05),but no significant difference was found between group P and group L. The count of TNF-αdescended in group H on d1,d3,d7 and ascended in group P on d1,d3,but restored to normal on d7. Group H, as well as group P, has statistical difference compared with group L (P﹤0.05). The count of IL-6 ascended in each group on d1, particularly in group P, and has statistical difference compared with that on d0 (P﹤0.05), and declined on d3 ,restored to normal on d7. Compared with group L , The count of IL-6 in Group P has statistical difference (P﹤0.05),but the group H has no statistical difference.Conclusions:Hydroxyethyl starch injection (33ml/kg) infusion during surgery can improve the immune function of patents with esophageal carcinoma and doesn't stimulate the inflammatory reaction after operation. Polygeline injection (33ml/kg) can produce a transient immunosuppression of patients with esophageal carcinoma on the early postoperative stage, but make it recover in time; meanwhile Polygeline injection can provoke inflammatory reaction. Hydroxyethyl starch injection infusion during surgery is better than polygeline injection in patients with esophageal carcinoma.