Abstract: Objective   To investigate the effect of sevoflurane and isoflurane in radical resection of lung cancer and their effects on the expression of serum matrix metalloproteinases(MMPs),inflammatory factors,E-selectin(E-selectin)and cyclooxygenase-2(COX-2)level effect. Methods   Lung cancer patients who underwent three-hole thoracoscopic radical resection for lung cancer from May 2017 to December 2020 were selected as the study objects,and were divided into observation group(intraoperative anesthesia maintained by sevoflurane)and control group(intraoperative anesthesia maintained by isoflurane)according to random number table,with 43 cases in each group.The level changes of matrix metalloproteinase-2(MMP-2),matrix metalloproteinase-9(MMP-9),E-selectin,COX-2,interleukin-4(IL-4),interleukin-10(IL-10) and interleukin-6(IL-6) of the two groups were compared before surgery(T0),1h after surgery(T1),after surgery(T2),and 6h after surgery(T3).Recovery time,extubation time,recovery of spontaneous respiration,and length of hospital stay were evaluated. Results   At T1,T2 and T3,the MMP-2 levels of the observation group were (328.11±23.15)ng/L,(335.41±23.85)ng/L,(342.52±25.52)ng/L,respectively.MMP-9 was (357.01±24.02)ng/L,(365.85±25.69)ng/L,(375.01±27.01)ng/L,respectively.E-selectin values were (59.11±6.02)ng/ml,(65.18±6.15)ng/ml,(57.25±5.69)ng/ml,respectively.COX-2 was (21.15±2.11)ng/ml,(22.05±2.18)ng/ml,(22.35±2.02)ng/ml,respectively.IL-4 was (14.11±2.65)ng/ml,(17.23±3.21)ng/ml,(22.01±3.96)ng/ml,respectively.IL-10 was (5.96±0.32)ng/ml,(7.25±0.58)ng/ml,(11.02±1.32)ng/ml,respectively.IL-6 was (44.12±3.41)ng/ml,(56.23±4.02)ng/ml,(57.14±4.09)ng/mlrespectively.In control group,MMP-2 was (341.52±25.45)ng/L,(368.78±28.74)ng/L,(381.02±31.03)ng/L,respectively.MMP-9 was (369.78±26.45)ng/L,(387.45±29.65)ng/L,(410.52±34.02)ng/L,respectively.E-selectin values were (64.12±7.25)ng/ml,(72.36±8.45)ng/ml,(62.15±6.45)ng/ml,respectively.COX-2 was (25.26±3.33)ng/ml,(25.35±3.28)ng/ml,(25.75±3.36)ng/ml,respectively.IL-4 was (15.96±3.12)ng/ml,(22.69±4.52)ng/ml,(27.41±4.32)ng/ml,respectively.IL-10 was (7.12±0.55)ng/ml,(9.96±1.02)ng/ml,(15.21±1.96)ng/ml,respectively.IL-6 was (59.78±4.85)ng/ml,(77.65±5.32)ng/ml,(62.65±5.05)ng/ml,respectively.The levels of MMP-2,MMP-9,E-selectin,COX-2,IL-4,IL-10 and IL-6 at T1,T2 and T3 in observation group were lower than those in control group(P<0.05).The recovery time of observation group and control group was (20.21±2.32)min and (27.12±3.15)min,respectively.The extubation time was (24.23±2.85)min and (30.15±3.14)min,and the recovery of spontaneous respiration was (10.25±1.23)min and (14.45±2.47)min,respectively.The observation group was shorter than the control group(P<0.05). Conclusion   Compared with isoflurane,sevoflurane has a better anesthesia effect in patients undergoing radical resection of lung cancer.It can inhibit inflammatory factors and reduce the stress response to MMP-2,MMP-9,The influence of E-selectin and COX-2.

Key words: sevoflurane, isoflurane, radical surgery for lung cancer, inflammatory factors, matrix metalloproteinases, cyclooxygenase, E-selectin