摘要
目的 观察异氟醚麻醉中人肺泡巨噬细胞IL-8、IL-1β基因表达的变化,以探讨异氟醚对肺炎性反应的影响。方法24例肝脏部分切除手术病人随机分为异氟醚全麻观察组（n=12）和硬膜外+全麻对照组（n=12）。两组病人均快速诱导,气管内插管,麻醉维持用药均包括异丙酚4～6mg·kg-1·h-1、芬太尼和维库溴铵。观察组吸入异氟醚,使呼气末异氟醚浓度保持在1.0％,对照组在诱导后经硬膜外注入1.0％利多卡因+0.2％丁卡因混合液5ml/h。在气管插管后即刻和4h用纤维支气管镜进行支气管肺泡灌洗,从灌洗液中收获肺泡巨噬细胞提取RNA,逆转录合成cDNA,PCR后电泳扫描求积,检测肺泡巨噬细胞IL-8、IL-1βmRNA的表达。结果 麻醉维持4h后比气管插管后即刻IL8-、IL-1βmRNA的表达增加,观察组比对照组IL-8、IL-1βmRNA的表达更强（P<0.05）。结论 异氟醚能增强肝脏部分切除病人肺泡巨噬细胞促炎性细胞因子mRNA的表达,即在转录水平上,异氟醚能增强肺部的炎性反应。
Objective To determine the changes in interleukin-8 (IL-8) and interleukin-1β(IL-1β) mRNA expressions in alveolar macrophages during isoflurane anesthesia. Methods Twenty-four ASA Ⅰ-Ⅱ male patients undergoing partial hepatectomy were randomly divided into two groups: group Ⅰ isoflurane; group Ⅱ general combined with epidural anesthesia. The age ranged from 43 to 67 years and body weight from 50 to 74kg. The patients were unpremedicated. Anesthesia was maintained with propofol infusion (4-6mg· kg-1·h-1 ) fentanyl and vecuronium in both groups. In addition 1% isoflurane was inhaled in group I and continuous epidural anesthesia with a mixture of 1 % lidocaine + 0.2% poutocaine (5ml/h) was performed in groupⅡ . ECG, SpO2, BP and HR were continuously monitored during anesthesia. Alveolar macrophages were harvested by bronchoalveolar lavage immediately and 4h after induction of anesthesia. RNA was extracted from harvested cells and cDNA was synthesized by reverse transcription. Expressions of IL-8 and IL-1β were measured by semiquantitative polymerase chain reaction using β-actin as an internal standard. Results Gene expression of IL-8 and IL-1β in alveolar macrophages increased significantly at 4h after induction of anesthesia. The increase was greater in group Ⅰ than in group Ⅱ( P < 0.05 ) . Conclusions Isoflurane anesthesia can increase the expression of genes for proinflammatory cytokines in alveolar macrophages. Inflammatory responses in the lung can be augmented by isoflurane at transcriptional levels.
出处
《中华麻醉学杂志》
CAS
CSCD
北大核心
2002年第8期459-461,共3页
Chinese Journal of Anesthesiology
基金
上海市领先学科基金资助项目(993027)
