地佐辛和舒芬太尼对结直肠癌患者术后早期血清VEGF和MMP-9水平的影响

doi:10.3760/cma.j.cn441417-20240624-14028

国际医药卫生导报 ›› 2025, Vol. 31 ›› Issue (14): 2429-2434.DOI: 10.3760/cma.j.cn441417-20240624-14028

地佐辛和舒芬太尼对结直肠癌患者术后早期血清VEGF和MMP-9水平的影响

吴昊¹ 文先杰¹ 罗兵² 杨凯¹ 凌晨¹ 刘幸清¹ 胡旭东¹

¹佛山市第二人民医院麻醉科，佛山 528000；²佛山市第二人民医院胃肠外科，佛山 528000

收稿日期:2024-06-24 出版日期:2025-07-01 发布日期:2025-08-06
通讯作者: 胡旭东，Email：huxudong65@163.com
基金资助:
广东省科技计划基金（2012A030400042）；佛山市医学科研基金（20240720A010240）

Effects of dezocine and sufentanil on serum levels of VEGF and MMP-9 in early period after surgery for patients with colorectal cancer

Wu Hao¹, Wen Xianjie¹, Luo Bing², Yang Kai¹, Ling Chen¹, Liu Xingqing¹, Hu Xudong¹

¹Department of Anesthesiology, Foshan Second People's Hospital, Foshan 528000, China; ²Department of Gastrointestinal Surgery, Foshan Second People's Hospital, Foshan 528000, China

Received:2024-06-24 Online:2025-07-01 Published:2025-08-06
Contact: Hu Xudong, Email: huxudong65@163.com
Supported by:
Guangdong Foundation for Scientific and Technological Program (2012A030400042); Foshan Medical Research Fund (20240720A010240)

摘要/Abstract

摘要：

目的　观察舒芬太尼和地佐辛对结直肠癌患者术后早期血清血管生长因子（vascular growth factor，VEGF）和基质金属蛋白酶-9（matrix metalloproteinase，MMP-9）水平的影响。方法　选取2024年1月至5月在佛山市第二人民医院择期行腹腔镜结直肠癌根治术的患者48例进行随机对照试验。采用随机数字表法将其分为SF组和DE组，每组24例。SF组年龄（65.42±11.44）岁，体重指数（body mass index，BMI）（21.81±4.23）kg/m²，美国麻醉医师协会（American Society of Anesthesiologists，ASA）分级Ⅱ～Ⅲ级。DE组年龄（66.38±12.04）岁，BMI（22.52±3.47）kg/m²，ASA分级Ⅱ～Ⅲ级。SF组采用舒芬太尼4 μg/kg进行术后患者自控镇痛，DE组采用地佐辛1.5 mg/kg进行术后患者自控镇痛。采用视觉模拟评量表（Visual Analogue Scale，VAS）评估两组术后2、12、24、48 h疼痛程度。记录两组恶心呕吐、头昏头痛、皮肤瘙痒、尿潴留和呼吸抑制的发生例数。比较两组血清血管内皮生长因子（vascular endothelial growth factor，VEGF）和金属基质蛋白酶-9（metallomatrix proteinase-9，MMP-9）水平。采用t检验和多因素重复测量方差分析行统计学分析。结果　两组术后2、12、24、48 h VAS评分差异均无统计学意义（均P>0.05）。两组术后恶心呕吐、头昏头痛、皮肤瘙痒、尿潴留和呼吸抑制发生率差异均无统计学意义（均P>0.05）。DE组术后2、24、48 h血VEGF水平均低于SF组［（235.48±19.57）ng/L比（243.21±23.65）ng/L、（220.98±26.49）ng/L比（233.57±32.48）ng/L、（213.72±20.89）ng/L比（229.65±28.36）ng/L］，差异均有统计学意义（均P<0.05）。两组术后2 h血MMP-9水平差异无统计学意义（P>0.05）；DE组术后24、48 h血MMP-9水平均低于SF组［（426.84±39.84）ng/L比（453.65±43.65）ng/L、（419.35±43.08）ng/L比（447.36±39.87）ng/L］，差异均有统计学意义（均P<0.05）。结论　与舒芬太尼相比，地佐辛可以更好地抑制结直肠癌患者术后早期血清VEGF和MMP-9的表达。

关键词: 地佐辛, 舒芬太尼, 结直肠癌, 手术, VEGF, MMP-9

Abstract:

Objective　To observe the effects of sufentanil and dezocine on the serum levels of vascular growth factor (VEGF) and matrix metalloproteinase 9 (MMP-9) in early period after surgery for patients with colorectal cancer. Methods　Forty-eight patients undergoing elective laparoscopic radical surgery for colorectal cancer in Foshan Second People's Hospital from January to May 2024 were selected for the randomized controlled trial, and were divided into an SF group and a DE group by the random number table method, with 24 cases in each group. The SF group were (65.42±11.44) years old; their body mass index (BMI) was (21.81±4.23) kg/m²; they were of American Society of Anesthesiologists (ASA) grade Ⅱ-Ⅲ. The DE group were (66.38±12.04) years old; their BMI was (22.52±3.47) kg/m²; they were of ASA grade Ⅱ-Ⅲ. The SF group received patient-controlled intravenous analgesia with 4 μg/kg of sufentanil, and the DE group with 1.5 mg/kg of dezocine. The pain degree was assessed 2, 12, 24, and 48 h after the operation using the Visual Analogue Scale (VAS). The numbers of cases of nausea and vomiting, dizziness and headache, itchy skin, urinary retention, and respiratory depression were recorded in both groups. The serum levels of metallomatrix proteinase-9 (MMP-9) and vascular endothelial growth factor (VEGF) were compared between the two groups. The t test and multivariate repeated measure analysis of variance were used for the statistical analysis. Results　There were no statistical differences in the scores of VAS 2, 12, 24, and 48 h after the operation between the two groups (all P>0.05). There were no statistical differences in the incidence rates of nausea and vomiting, dizziness and headache, itchy skin, urinary retention, and respiratory depression between the two groups (all P>0.05). The serum levels of VEGF 2, 24, and 48 h after the operation in the DE group were lower than those in the SF group [(235.48±19.57) ng/L vs. (243.21±23.65) ng/L, (220.98±26.49) ng/L vs. (233.57±32.48) ng/L, and (213.72±20.89) ng/L vs. (229.65±28.36) ng/L], with statistical differences (all P<0.05). There was no statistical differences in the serum level of MMP-9 2 h after the operation between the two groups (P>0.05); the serum levels of MMP-9 24 and 48 h after the operation in the DE group were lower than those in the SF group [(426.84±39.84) ng/L vs. (453.65±43.65) ng/L and (419.35±43.08) ng/L vs. (447.36±39.87) ng/L], with statistical differences (both P<0.05). Conclusion　Dezocine can better inhibit serum VEGF and MMP-9 expression in patients in early period after colorectal cancer surgery than sufentanil.

Key words: Dezocine, , Sufentanil, , Colorectal cancer, , Surgery, , VEGF, , MMP-9

吴昊文先杰罗兵杨凯凌晨刘幸清胡旭东.

地佐辛和舒芬太尼对结直肠癌患者术后早期血清VEGF和MMP-9水平的影响 [J]. 国际医药卫生导报, 2025, 31(14): 2429-2434.

Wu Hao, Wen Xianjie, Luo Bing, Yang Kai, Ling Chen, Liu Xingqing, Hu Xudong.

Effects of dezocine and sufentanil on serum levels of VEGF and MMP-9 in early period after surgery for patients with colorectal cancer [J]. International Medicine and Health Guidance News, 2025, 31(14): 2429-2434.

参考文献

[1]Dekker E, Tanis PJ, Vleugels JLA, et al. Colorectal cancer[J]. Lancet, 2019, 394(10207): 1467-1480. DOI: 10.1016/S0140-6736(19)32319-0.

[2]Engstrand J, Nilsson H, Strömberg C, et al. Colorectal cancer liver metastases - a population-based study on incidence, management and survival[J]. BMC Cancer, 2018, 18(1): 78. DOI: 10.1186/s12885-017-3925-x.

[3]Kim SH, Suh YS, Lee DE, et al. A retrospective comparative study of progression-free survival and overall survival between metachronous and synchronous metastatic renal cell carcinoma in intermediate- or poor-risk patients treated with VEGF-targeted therapy[J]. Oncotarget, 2017, 8(55): 93633-93643. DOI: 10.18632/oncotarget.20674.

[4]Lin C, Xu Z, XinLiang, et al. A randomized controlled trial to compare the effect of oxycodone and sufentanil on postoperative analgesia and immune function for laparoscopic resection of colorectal cancer[J]. BMC Anesthesiol, 2025, 25(1): 58. DOI: 10.1186/s12871-025-02922-5.

[5]Yang S, Hu J. Comparison of postoperative analgesia between dezocine plus flurbiprofen axetil and sufentanil in patients with CRC undergoing tumor resection: A prospective, observational study[J]. Oncol Lett, 2025, 29(3): 121. DOI: 10.3892/ol.2025.14869.

[6]Kamal Y, Schmit SL, Frost HR, et al. CI. The tumor microenvironment of colorectal cancer metastases: opportunities in cancer immunotherapy[J]. Immunotherapy, 2020, 12(14): 1083-1100. DOI: 10.2217/imt-2020-0026.

[7]Peltonen R, Gramkow MH, Dehlendorff C, et al. Elevated serum YKL-40, IL-6, CRP, CEA, and CA19-9 combined as a prognostic biomarker panel after resection of colorectal liver metastases[J]. PLoS One, 2020, 15(8): e0236569. DOI: 10.1371/journal.pone.0236569.

[8]Shasha T, Gruijs M, van Egmond M. Mechanisms of colorectal liver metastasis development[J]. Cell Mol Life Sci, 2022, 79(12): 607. DOI: 10.1007/s00018-022-04630-6.

[9]田燕,袁权,王虎霞,等. ABUS联合血清VEGF、CEA对乳腺癌的诊断价值[J]国际医药卫生导报, 2024, 30(5): 740-743. DOI: 10.3760/cma.j.issn.1007-1245.2024.05.007

[10]Canavese M, Ngo DT, Maddern GJ, et al. Biology and therapeutic implications of VEGF-A splice isoforms and single-nucleotide polymorphisms in colorectal cancer[J]. Int J Cancer, 2017, 140(10): 2183-2191. DOI: 10.1002/ijc.30567.

[11]Peltonen R, Gramkow MH, Dehlendorff C, et al. Elevated serum YKL-40, IL-6, CRP, CEA, and CA19-9 combined as a prognostic biomarker panel after resection of colorectal liver metastases[J]. PLoS One, 2020, 15(8): e0236569. DOI: 10.1371/journal.pone.0236569.

[12]Wen Y, Wang M, Yang J, et al. A comparison of fentanyl and flurbiprofen axetil on serum VEGF-C, TNF-α, and IL-1β concentrations in women undergoing surgery for breast cancer[J]. Pain Pract, 2015, 15(6): 530-537. DOI: 10.1111/papr.12206.

[13]Feng T, Zeng S, Ding J, et al. Comparative analysis of the effects of opioids in angiogenesis[J]. BMC Anesthesiol, 2021, 21(1): 257. DOI: 10.1186/s12871-021-01475-7.

[14]Yamamizu K, Hamada Y, Narita M. κ Opioid receptor ligands regulate angiogenesis in development and in tumours[J]. Br J Pharmacol, 2015, 172(2): 268-276. DOI: 10.1111/bph.12573.

[15]Yang ZH, Shen R, Zhan FF, et al. Effects of dezocine combined with dexmedetomidine on adverse reactions and inflammatory factors in patients undergoing HIPEC after intestinal surgery and its protective effect on the heart in the perioperative period[J]. Eur Rev Med Pharmacol Sci, 2022, 26(10): 3437-3443. DOI: 10.26355/eurrev_202205_28837.

[16]Hu X, Luo B, Wu Q, et al. Effects of dezocine and sufentanil on Th1/Th2 balance in breast cancer patients undergoing surgery[J]. Drug Des Devel Ther, 2021, 15: 4925-4938. DOI: 10.2147/DDDT.S326891.

[17]Zhang C, Pan R, Ma S, et al. Dezocine inhibits cell proliferation, migration, and invasion by targeting CRABP2 in ovarian cancer[J]. Open Med (Wars), 2022, 17(1): 2052-2061. DOI: 10.1515/med-2022-0541.

[18]Rashid ZA, Bardaweel SK. Novel matrix metalloproteinase-9 (MMP-9) inhibitors in cancer treatment[J]. Int J Mol Sci, 2023, 24(15): 12133. DOI: 10.3390/ijms241512133.

[19]He L, Kang Q, Chan KI, et al. The immunomodulatory role of matrix metalloproteinases in colitis-associated cancer [J]. Front Immunol, 2023, 13: 1093990. DOI: 10.3389/fimmu.2022.1093990.

[20]Mudatsir, Labeda I, Uwuratuw JA, et al. Relationship between metalloproteinase-9 (MMP-9) expression and clinicopathology in colorectal cancer: a cross-sectional study[J]. Ann Med Surg (Lond), 2023, 85(9): 4277-4282. DOI: 10.1097/MS9.0000000000000892.

[21]Peltonen R, Hagström J, Tervahartiala T, et al. High expression of MMP-9 in primary tumors and high preoperative MPO in serum predict improved prognosis in colorectal cancer with operable liver metastases[J]. Oncology, 2021, 99(3): 144-160. DOI: 10.1159/000510609.

[22]Khabbazi S, Hassanshahi M, Hassanshahi A, et al. Opioids and matrix metalloproteinases: the influence of morphine on MMP-9 production and cancer progression[J]. Naunyn Schmiedebergs Arch Pharmacol, 2019, 392(2): 123-133. DOI: 10.1007/s00210-019-01613-6.

[23]Khabbazi S, Hassanshahi M, Hassanshahi A, et al. Opioids and matrix metalloproteinases: the influence of morphine on MMP-9 production and cancer progression[J]. Naunyn Schmiedebergs Arch Pharmacol, 2019, 392(2): 123-133. DOI: 10.1007/s00210-019-01613-6.

[24]Li C, Qin Y, Zhong Y, etr al. Fentanyl inhibits the progression of gastric cancer through the suppression of MMP-9 via the PI3K/Akt signaling pathway[J]. Ann Transl Med, 2020, 8(4): 118. DOI: 10.21037/atm.2019.12.161.

[25]Carvalho NS, Moron AF, Witkin SS, et al. Histological response and expression of collagen, metalloproteinases MMP-1 and MMP-9 and tissue inhibitors of metalloproteinases TIMP-1 and TIMP-2 in fetal membranes following open intrauterine surgery: an experimental study[J]. J Matern Fetal Neonatal Med, 2022, 35(7): 1301-1309. DOI: 10.1080/14767058.2020.1752654.

地佐辛和舒芬太尼对结直肠癌患者术后早期血清VEGF和MMP-9水平的影响

Effects of dezocine and sufentanil on serum levels of VEGF and MMP-9 in early period after surgery for patients with colorectal cancer

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