| Summary: | Objective To investigate the effect of flurbiprofen axetil pretreatment on perioperative oxidative stress and Apelin in patients with type 2 diabetes mellitus. Methods A total of 100 patients scheduled to undergo spinal surgery were recruited. Among them, 65 patients with diabetes mellitus were randomly divided into the pretreatment group （n = 32） and blank control group （n = 33）. In the pretreatment group, patients were pretreated with flurbiprofen axetil injection at a dose of 1.0 mg/kg at 10 min before anesthesia induction, and those in the blank control group received routine anesthesia without pretreatment. Non-diabetic patients were assigned into the normal control group （n = 35）, who were not given with pretreatment. The changes of the serum levels of Apelin-13, Ang Ⅱ, MDA, IL-6, blood glucose were observed at preoperative （T0）, intraoperative 1 h （T1） and postoperative 1 h （T2） time points, respectively. Meantime, the white blood cell count （WBC）and neutrophil percentage（NEUT%） were compared before and 1 d after operation. Results The serum levels of Ang Ⅱ, MDA and IL-6 in all three groups showed a trend of initial increase （T0-T1） and then decline （T1-T2）, and the levels at T2 were higher than those at T0. However, the serum levels of Apelin-13 were initially decreased and then increased, and the levels at T2 were significantly lower compared with those at T0 （all P < 0.05）. Compared with the normal control group, all serum indexes at the same time point were increased, blood glucose fluctuation was enlarged, and postoperative WBC and NEUT% were increased in the pretreatment and blank control groups. Compared with the blank control group, the serum level of Apelin-13 was significantly up-regulated, those of IL-6, MDA and Ang Ⅱ were significantly decreased, and postoperative WBC, NEUT% and blood glucose fluctuation were significantly decreased in the pretreatment group （all P < 0.05）. Conclusion Flurbiprofen axetil preconditioning can regulate the serum level of Apelin-13, lower inflammatory factors and oxidative stress indexes to certain extent, inhibit the increase of WBC and NEUT% after operation, and mitigate perioperative oxidative stress and blood glucose fluctuation in diabetic patients.
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