异丙酚对肺缺血再灌注损伤大鼠肺上皮细胞凋亡的影响  

Effect of propofol on apoptosis in lung epithelial cells in a rat model of lung ischemia-reperfusion injury

作　　者：詹美俊[1] 姚尚龙[1] 张诗海[1] 

机构地区：[1]华中科技大学同济医学院附属协和医院麻醉科,武汉市430022

出　　处：《中华麻醉学杂志》2007年第6期558-561,共4页Chinese Journal of Anesthesiology

摘　　要：目的拟通过观察肺上皮细胞凋亡的变化,探讨异丙酚减轻大鼠肺缺血再灌注损伤的作用机制。方法雄性SD大鼠136只,随机分为3组：假手术组（S组,n=24）、缺血再灌注组（I/R组,n=56）、异丙酚组（P组,n=56）。I/R组、P组制备大鼠肺原位热缺血模型,缺血1h。P组于缺血前30min静脉输注异丙酚20mg·kg^-1·h^-1至再灌注4h。S组除不作缺血处理外,其余处理与I／R组相同。分别于再灌注0．5、1、2、4h随机处死大鼠（S组每个时点处死6只,I/R组、P组每个时点分别处死14只大鼠）,每组每个时点的一半大鼠用于测定支气管肺泡灌洗液（BALF）中中性粒细胞百分比、蛋白浓度,另外一半大鼠用于测定肺组织丙二醛（MDA）含量、湿,干重比（W/D）及肺上皮细胞凋亡指数（TUNEL法）,并在光镜下观察肺组织的病理学改变；I/R组、P组肺上皮细胞凋亡指数与W/D进行直线相关分析。结果与S组相比,I/R组和P组再灌注各时点BALF中中性粒细胞百分比、蛋白浓度及肺组织MDA含量、W/D、肺上皮细胞凋亡指数均增加（P＜0．05或0．01）；与I/R组比较,P组上述指标均降低（P＜0．05或0．01）,肺组织病理学损伤减轻；I/R组、P组肺上皮细胞凋亡指数与W/D之间的相关系数分别为0．784、0．830（P＜0．01）。结论异丙酚抑制肺上皮细胞凋亡可能是减轻大鼠肺缺血再灌注损伤的机制之一。Objective To investigate the effect of propofol on apoptosis in the lung epithelial cells in a rat model of lung ischemia-reperfusion （I/R） injury. Methods One hundred and thirty-six male SD rats weighing 250-300 g were randomized into 3 groups ： group Ⅰ sham operation （ n = 24） ; group Ⅱ I/R （ n = 56） and group Ⅲ propofol ＋ I/R （ n = 56）. The animals were anesthetized with intraperitoneal 4% pentobarbital 50 mg/kg and tracheostomized and mechanically ventilated. PETCO2 was maintained at 35-45 mm Hg. Lung I/R was induced by left thoracotomy and the exposure of hilum of the left lung and occlusion of left main bronchus and pulmonary artery and vein with atraumatic mini-clamp for 1 h. The mini-clamp was then released for reperfusion, In prepofol group propofol infusion （ 20 mg·kg^-1·h^-1 ） was started at 30 min before ischemia and continued until the end of reperfusion. In group Ⅱ （I/R） and Ⅲ （propofol） 14 animals each were killed at 0.5, 1, 2 and 4 h of reperfusion. The left lung was removed for （1） broncho-alveolar lavage and determination of percentage of neutrophils and protein content in the broncho-alveolar lavage fluid （BALF） ; （2） W/D lung weight ratio and MDA content in the lung and apoptosis index of lung epithelial cells （TUNEL）. Results The percentage of neutrophils and protein concentration in BALF, the MDA content in the lung, the W/D ratio and apoptosis index were significantly increased in I/R and propofol group as compared with sham operation group. The I/R induced changes were significantly attenuated by propofol infusion. Apoptosis index was directly correlated with W/D ratio in I/R and propofol group. Conclusion Inhibition of apoptosis in lung epithelial cells is involved in the mechanism of the protective effect of prepofol against lung I/R in rats.

关 键 词：二异丙酚 再灌注损伤 肺 上皮细胞 细胞凋亡 

分 类 号：R686[医药卫生—骨科学]