摘要
目的探讨异氟醚对大鼠肺缺血再灌注损伤的保护作用。方法 120只SD雄性大鼠, 随机分成4组(n=30):假手术组(S组)、缺血再灌注组(IR组)、异氟醚-缺血再灌注组(ISO-IR组)和异氟醚组(ISO-S组)。IR组、ISO-IR组建立肺缺血再灌注模型,ISO-IR组吸入1MAC异氟醚30 min时行肺缺血再灌注,ISO-S组吸入1MAC异氟醚,不进行肺缺血再灌注。分别在缺血45 min、再灌注30、 60、120min处死6只大鼠,测定肺组织湿干比(W/D)、髓过氧化物酶(MPO)活性、中性粒细胞(PMN)膜表面CD18和肺组织ICAM-1 mRNA表达、支气管肺泡灌洗液(BALF)中白细胞计数、沉渣白细胞分类和总蛋白(TP)浓度,并进行肺组织病理学检查。结果再灌注期间IR组肺组织W/D、MPO活性、CD18 和ICAM-1 mRNA表达、BALF中PMN百分比、TP浓度及PMN膜表面CD18表达均升高,而异氟醚预先给药减弱了缺血再灌注诱导的上述指标的升高。肺组织病理学检查显示异氟醚预先给药减轻了肺缺血再灌注损伤。结论通过抑制PMN浸润和肺组织ICAM-1 mRNA及CD18表达上调,缺血前吸入异氟醚对肺缺血再灌注损伤有一定的保护作用。
Objective To investigate the effect of isoflurane administered before ischemia on polymorphonuclear neutrophil （PMN） infiltration and expression of adhesion molecules in the lung injured by ischemia-reperfusion. Methods One-hundred and twenty male SD rats weighing 250-350 g were randomly divided into 4 groups （ n = 30 each） ： I sham operation group （S） ; I/ I/R group in which hilum of left lung was clamped for 45 min and then unclamped for reperfusioni llI Iso ＋ I/R in which 1 MAC isoflurane was inhaled for 30 min before ischemia and IV Iso ＋ S in which 1 MAC isoflurane was inhaled for 30 min without I/R. The animals were anesthetized with intraperitoneal pentobarbital 50 mg＂ kg- ~ then tracheostomized and mechanically ventilated with 100% Oz（Vv = 10-15 ml. kg-＇）. PaCO2 was maintained at 35-45 mm Hg. Right jugular vein and left carotid artery were cannulated for BP monitoring, blood sampling and fluid and drug administration. Anesthesia was maintained with ketamine 10 mg＂ kg-~ ~ h- ~ and vecuronium 0.1 mg＂ kg ~ ~ h- ~ . 1 MAC isoflurane （ 1.38% in rats） was inhaled for 30 min before hilum of left lung was clamped with an atraumatic clamp. Left lung ischemia was maintained for 45 min then the left lung was released for reperfusion. MAP was monitored and blood gases were analyzed during experiment. The animals were killed at the end of 45 minute ischemia and at 30, 60 and 120 min reperfusion and left lung was removed for： （1） determination of W/D lung weight ratio, myeloperoxidase （MPO） activity and expression of ICAM-1 mRNA; （2） light and electron microscopic examination; （3） broncho-alveolar lavage （BAL）. BAL fluid （BALF） was collected and the number of ceils, percentage of PMN and total protein concentration in BALF and the expression of CD18 on PMN surface were determined. Results The W/D lung weight ratio, MPO activity and expression of ICAM-1 mRNA in the lung tissue, the percentage of PMN and TP concentration in BALF and the expression of CD18 on PMN surface were all significantly increased during reperfusion in I/R group but isoflurane pretreatment significantly attenuated the I/R induced increases. Histological examination showed that the I/R induced lung injury was also ameliorated by isoflurane pretreatment. Conclusion Inhalation of isoflurane before ischemia could protect the lungs against I/R injury by inhibiting the PMN infiltration and expression of ICAM-1 mRNA and CD-18.
出处
《中华麻醉学杂志》
CAS
CSCD
北大核心
2006年第2期140-143,共4页
Chinese Journal of Anesthesiology
关键词
异氟醚
肺
再灌注损伤
Isoflurane
Lung
Reperfusion injury
