摘要
目的观察持续气道正压(continuous positive airway pressure,CPAP)对高龄肺癌患者单肺通气(one-lung ventilation,OLV)中非通气侧肺泡灌洗细胞IL-1β和IL-8mRNA的表达,在分子水平上探讨CPAP对肺炎性反应的影响。方法选择单肺通气下年龄>65岁的肺癌开胸手术患者28例,ASAⅠ～Ⅱ级,随机分为对照组(n=14)和CPAP组(n=14)。对照组在麻醉期间非通气侧肺的支气管导管直接开口于大气中,CPAP组麻醉期间非通气侧肺持续给予CPAP(压力3～5cmH2O,1cmH2O=1.02Pa)。在单肺通气开始和通气2h后分别对两组患者非通气侧肺用纤维支气管镜行支气管肺泡灌洗(bronchoalveolar lavage,BAL),从灌洗液中收获细胞提取RNA,逆转录合成cDNA,以-βactin为内标准作PCR后电泳扫描求积,检测肺泡灌洗细胞IL-1β和IL-8mRNA的表达。结果单肺通气2h后,对照组比CPAP组非通气侧肺肺泡灌洗液中IL-8和IL-1βmRNA的表达显著增加(P<0.01)。结论单肺通气中非通气侧肺给予适度的CPAP可以有效减少高龄肺癌患者肺泡灌洗细胞促炎性细胞因子mRNA的表达水平,抑制肺局部炎症反应,对非通气侧肺可能有一定的保护作用。
Objective To investigate the effects of continuous positive airway pressure（CPAP） on the expression of IL-1β and IL-8 mRNA in alveolar lavage cells of old patients with lung tumor during one-lung ventilation（OLV）. Methods Twenty-eight patients with lung tumor,ASA Ⅰ-Ⅱ,aged above 65 years old who underwent lobectomy were randomly divided into CPAP group（n=14） and control group（n=14）.There was no ventilation on the non-ventilated lung which was opened to the air in control group.Oxygen was administered via CPAP（Pressure 3-5 cmH_2O,1 cmH_2O=1.02 Pa） system to the non-ventilated lung during OLV in CPAP group.Alveolar lavage cells were harvested by bronchoalveolar lavage at the beginning of OLV and 2 hours after OLV.RNA was extracted from the harvested cells and cDNA was synthesized by reverse transcription.The expression of IL-8 and IL-1β mRNA was measured by semi-quantitative PCR with β-actin as an internal standard. Results The expressions of IL-1β and IL-8 mRNA was significantly higher 2 hours after OLV than that at the beginning of OLV in control group.The increase was slight in CPAP group.There were statistical differences in IL-8 and IL-1β mRNA expressions between CPAP group and control group was significant （P0.01）.Conclusions CPAP used during OLV in old patients with lung tumor may reduce the expressions of IL-1β and IL-8 mRNA in alveolar lavage cells,which can inhibit inflammatory responses in the lungs.CPAP may provide a protective effect on non-ventilated lung.
出处
《复旦学报（医学版）》
CAS
CSCD
北大核心
2011年第2期141-143,共3页
Fudan University Journal of Medical Sciences
关键词
持续气道正压
单肺通气
细胞因子
逆转录-聚合酶链反应
支气管肺泡灌洗
continuous positive airway pressure
one-lung ventilation
cytokines
reverse transcriptase PCR
bronchoalveolar lavage
