摘要:目的 通过观察胆囊切除术患者围手术期使用氯诺昔康后血清中白细胞介素-2（IL-2）、白细胞介素-6（IL-6）、白细胞介素10（IL-10）水平的变化，探讨氯诺昔康对机体细胞免疫功能的影响。方法 择期行开腹胆囊切除术患者40例，术前常规使用鲁米那加阿托品。随机双盲分为A、B两组，每组20例。A组在麻醉前静脉滴注氯诺昔康8mg，术后以芬太尼行静脉自控镇痛（PCIA）；B组关腹结束即刻静脉滴注氯诺昔康8mg，术后以芬太尼行PCIA。两组分别于麻醉用药前（T1）、关腹结束后即刻用药前(T2)、术后6小时(T3)、术后24小时(T4)抽取外周静脉血，测定各个时点血清炎性细胞因子IL-2、IL-6及IL-10水平。结果 两组患者T1时点血清IL-2、IL-6、IL-10浓度差异无统计学意义（P＞0.05）,T2、T3、T4时点的IL-2、IL-6浓度B组显著高于A组，差异有统计学意义（P＜0.05）；在T2、T3、T4时点的IL-10水平B组显著低于A组，差异有统计学意义（P＜0.05）。结论 术前使用氯诺昔康，较术后使用更能减轻麻醉手术等因素对细胞免疫功能的抑制，并能有效抑制应激反应，有利于术后恢复。

Abstract：Objective To explore the effects of Lornoxlcam on the serum of IL-2，IL-6 and IL-I0 in perioperative period of patients undergoing cholecystectomy and to study the mechanism of Lornoxicam on immunologic function. Methods forty patients scheduled for cholecystectomy operations were randomly allocated to either A or B group, each with 20 cases. The luminal and atropine was routinely used before operations. The patients in group A were intravenous dripped with 8mg of Lornoxicam before anesthesia, and then given Sufentanil to patient controlled intravenous anesthesia (PCIA). The patients in group B were intravenous dripped with 8mg of Lornoxicam at the end of the abdominal closure, and then given Sufentanil to the PCIA. The serum of interleukin-2 (IL-2)，Interleukin-6 (IL-6) and Interleukin-10 (IL-10) in all patients were measured at prior to anesthesia medication (T1), abdominal closure end immediately (T2), 6 hours after surgery (T3) and 24 hours after surgery (T4). Results There was no significant difference between the two groups in the levels of IL-2, IL-6 and IL-10 at T1 time point s(P＞0.05). The levels of IL-2 and IL-6 in group B were significantly higher than that of in group A at the T2, T3 and T4 time points (P＜0.05). The levels of IL-10 in group B were significantly lower than that in group A at the T2, T3 and T4 time points (P＜0.05). Conclusion Compare with the post-operation, the preoperative use of Lornoxicam could mitigate factors such as anesthesia, surgery on the inhibition of cellular immune function, and can effectively inhibit stress response in favor of postoperative recovery.