山莨菪碱对通气机所致大鼠肺损伤防护作用的实验研究  

Protective effects of anisodamine on ventilator-induced lung injury in rats

作　　者：刘庆辉[1] 刘岩[1] 夏文俊[1] 石敏[1] 俞森洋[1] 

机构地区：[1]解放军总医院南楼呼吸科,北京100853

出　　处：《解放军医学杂志》2007年第11期1157-1159,共3页Medical Journal of Chinese People's Liberation Army

摘　　要：目的研究山莨菪碱(ADM)对大鼠通气机所致肺损伤(VILI)的防护作用。方法将36只健康雄性SD大鼠随机分为3组,实施麻醉和气管切开后,吸入空气进行机械通气,通气时间均为4h。A组为对照组,进行常规通气,潮气量8ml/kg,呼吸频率40/min;B组为致伤组,进行大潮气量通气,潮气量40ml/kg,呼吸频率20/min;C组为ADM防护组,分别在通气开始前24、12h及通气开始后0h经尾静脉注射ADM(15mg/kg),潮气量和呼吸频率同B组。每小时行1次动脉血气分析。行支气管肺泡灌洗液(BALF)中的中性粒细胞计数,测定左肺湿/干(W/D)值,血清和BALF中TNF-α、IL-1β水平,血清和肺组织中丙二醛(MDA)、超氧化物歧化酶(SOD)水平,观察肺脏的组织病理学改变。结果B组大鼠氧合指数(PaO2/FiO2)较A、C组显著下降,BALF中性粒细胞计数显著增加,左肺W/D值较A、C组显著升高。B组大鼠血清和BALF中TNF-α、IL-1β水平较A组显著增高,而C组较B组显著降低。C组大鼠血清和肺组织中MDA水平较B组显著下降,而SOD水平较B组显著升高。组织病理学显示B组大鼠肺脏内较A、C组有更多的中性粒细胞浸润和肺泡壁结构的破坏。结论ADM通过其抗炎和抗氧化作用对大鼠VILI起防护作用。Objective To study the protective effects of anisodamine （ADM） on ventilator-induced lung injury （VILI） in rats. Methods After anesthesia was induced and tracheostomy was performed, 36 healthy male Sprague-Dawley rats were randomly assigned into three groups： control group （group A, VT=8ml/kg）l injury group （group B）, in which the animals received mechanical ventilation with large tidal volume （VT=40ml/kg） . and ADM protective group （group C）, in which the animals received the same amount of tidal volume and same respiratory rate with mechanical ventilation as in group B, but were pre-treated with ADM （15mg/kg · iV） at 24h, 12h, Oh time points before ventilation. Arterial blood gases were measured every one hour, and neutrophils in bronchoalveolor lavage fluid （BALF） were counted. Wet to dry （W/D） weight ratio of left lung was detenTdned, and the content of TNF-α and IL-1β in BALF and blood, malondialdehyde （MDA）, superoxide dismutase （Sxr）D） levels in the pulmonary tissue and blood were measured respectively. The histopathological changes in pulmonary tissues in the three groups were compared, Reasts The oxygenation index （PaO2/FiO2） of the animals in group B was significantly lower than that in group A and C, and the BALF neutrophil count was remarkably increased in group B. W/D value of group B was significantly higher than that of group A and C. The levels of TNF-α, ID-1β in BALF were remarkably increased in group B [（564±25）ng/L, （118±9）ng/L], but decreased in group C [（357±18）ng/L, （91±8）ng/L]. MDA levels in pulmonary tissue and blood in group C were lower than that of group B, but SOD level in group C was significantly higher than that of group B. Histopathologic findings demonstrated there were more neutrophil infiltration and destructive change in the alveolar wall in group B than in other groups. Conclusion ADM appears to have obvious protective effects on VILI through anti-inflammation and antioxidatio.n.

关 键 词：通气机 机械 急性肺损伤 肿瘤坏死因子 白细胞介素1 丙二醛 超氧化物岐化酶 

分 类 号：R563.9[医药卫生—呼吸系统]