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Fever as a defense system of the body to surgical stress-Its physiological investigation and relationship to anesthesia

发热作为机体对手术应激的防御系统——其生理学研究及其与麻醉的关系

基本信息

批准号：
08671772
负责人：
OZAKI Makoto
金额：
$ 1.47万
依托单位：
Tokyo Women's Medical University
依托单位国家：
日本
项目类别：
Grant-in-Aid for Scientific Research (C)
财政年份：
1996
资助国家：
日本
起止时间：
1996 至 1998
项目状态：
已结题

来源：
https://kaken.nii.ac.jp/grant/KAKENHI-PROJECT-08671772/
关键词：
Anesthesia Cytokines Fever Pyrogen Temperature Hyperthermia Surgical Stress IL-1(α,β)IL-6 TNFα INFα MIP-1(α,β)

项目摘要

No matter how strictly the surgeons perform operation aseptically, 90% of the 1^<st> post-operative-day patients have significant fever. We found these post-operative fever had tight relationship with cytokines such as IL-1 (alpha, beta), IL-6, TNFalpha, INFalpha, MIP-1(alpha, beta). Surgical stress also provoke the release of various types of cytokines, especially IL-6 is known as sensitive cytokines to intensity of surgical stress and depth of anesthesia.In this study, we investigated the interactions between fever and plasma cytokines changes during surgery and post-operatively. We also studied volunteers, each was given an intravenous injection of 50,000 IU/kg of interleukin-2 followed 2 hours later by 100,000 IU/kg. Volunteers were assigned randomly to three doses of desflurane to induce anesthesia : (1) 0.0 minimum alveolar concentration (MAC ; control), (2) 0.6 MAC and (3) 1.0 MAC.Desflurane-induced anesthesia produced a dose-dependent decrease in integrated and peak core temperatures after administration for pyrogen, with 1.0 MAC essentially obliterating fever. Anesthetic-induced inhibition of the pyrogenic response is therefore one reason that fever is an inconsistent clinical response to inflammation during surgery.

无论外科医生如何严格执行无菌操作，90%的1^<st bb0术后患者出现明显发热。我们发现这些术后发热与IL-1 （α, β）、IL-6、TNFalpha、INFalpha、MIP-1（α, β）等细胞因子密切相关。手术应激也引起多种细胞因子的释放，尤其是IL-6是对手术应激强度和麻醉深度敏感的细胞因子。在这项研究中，我们研究了手术中和术后发热与血浆细胞因子变化之间的相互作用。我们还研究了志愿者，每人静脉注射50,000 IU/kg的白细胞介素-2,2小时后静脉注射100,000 IU/kg。志愿者被随机分配到三种剂量的地氟醚来诱导麻醉：(1)0.0最低肺泡浓度（MAC；对照），(2)0.6 MAC和(3)1.0 MAC。地氟醚诱导的麻醉在给药热原后产生了剂量依赖性的综合和峰值核心温度下降，1.0 MAC基本上消除了发烧。因此，麻醉诱导的热原反应的抑制是手术期间发烧是一种不一致的临床炎症反应的原因之一。