氯胺酮抗兔肺缺血-再灌注损伤的实验研究  

Experimental research of Ketamine against lung ischemia-reperfusion injury in rabbits

作　　者：习建华[1] 林丽娜[1] 金立达[1] 王万铁[2] 金小凤[2] 许益笑[2] 王青[2] 

机构地区：[1]温州医学院第一附属医院麻醉科,浙江温州325035 [2]温州医学院病理生理学教研室,浙江温州325035

出　　处：《温州医学院学报》2007年第4期337-340,共4页Journal of Wenzhou Medical College

基　　金：温州市科技计划重点项目(Y2005A080)。

摘　　要：目的:观察氯胺酮对兔肺缺血-再灌注损伤的保护作用。方法:实验兔50只随机均分为对照组(C组)、缺血-再灌注组(IR组)和缺血-再灌注+氯胺酮预注组(Ket组)。测量血浆中肿瘤坏死因子-α(TNF-α)、一氧化氮(NO)、丙二醛(MDA)含量,分析每组肺湿干重比(W/D)、肺泡损伤数(IQA)及肺组织形态改变情况。结果:IR组与C组相比,NO含量显著降低(P<0.01),TNF-α、MDA、W/D、IQA明显升高(P<0.01)。Ket组与IR组相比,NO含量明显升高(P<0.05),TNF-α、MDA、W/D、IQA有不同程度降低(P<0.01或P<0.05)。光镜下C组肺泡较完整,未见炎症细胞浸润;IR组肺不张,肺间质水肿,炎症细胞浸润,而Ket组肺损伤明显减轻,炎症细胞浸润少。结论:氯胺酮可抑制炎性因子的释放和过氧化反应,增加一氧化氮含量,减轻肺血管内皮细胞损伤,从而对缺血再灌注损伤的肺组织起到保护作用。Objective：To evaluate the protective effect of ketamine against lung ischemia-reperfusion injury in rabbits. Methods ： Fifty Rabbits were randomly divided into three groups： the control group （group C）, ischemia-reperfusion group （group IR） and the ischemia-reperfusion plus ketamine pre-injection group （group Ket）. The contents of nitric oxide（NO）, tumor necrosis factor-α （TNF-α） and malondialdehyde （MDA） in plasma were mesured as well as the wet to dry weight ratio of lung tissue（W/D）, the index of quantitative assessment of histologic lung injury （IOA） and the morphological change of lung tissue were analysed in each group. Results ： There were less NO and more MDA, TNF-α in contents and higher value of W/D, IQA in group IR than those in group C （P〈0.01）. More NO in content and lower value of MDA, W/D, TNF-α , IQA were found in group Ket in comparison with group IR （P〈0.05 or P〈0.01）. Alveolus was more integrated and no infiltration of inflammatory cell was found in group C under light microscopy. Atelectasis, interstitial pulmonary edema and infiltration of inflammatory cells were observed in group IR while pulmonary injury and infiltration of inflammatory cell were reduced in group Ket. Conclusion： Ketamine may have protective effect on lung ischemia-reperfusion injury by inhibiting peroxidation and the release of inflammatory factors,increasing the content of NO and decreasing the injury of pulmonary vascular endothelium.

关 键 词：氯胺酮 肺 再灌注损伤 一氧化氮 丙二醛 肿瘤坏死因子-Α 

分 类 号：R363.2[医药卫生—病理学]