不同浓度异氟醚预处理对内毒素性急性肺损伤肺泡毛细血管通透性的影响  

Effects of the Different Concentration of Isoflurane Pretreatment on the Alveolar Capillary Permeability with Acute Lung Injury Induced by Endotoxin

作　　者：孙敏莉[1] 缪长虹[1] 薛张纲[1] 

机构地区：[1]复旦大学附属中山医院麻醉科,上海200032

出　　处：《中国临床医学》2008年第2期255-257,共3页Chinese Journal of Clinical Medicine

基　　金：中华人民共和国卫生部重点学科项目(2005~2007)

摘　　要：目的：比较0．5肺泡气最低有效浓度（MAC）、1．0MAC及1．3MAC3种浓度异氟醚预处理对内毒素诱导幼猪急性肺损伤肺泡毛细血管通透性的影响。方法：24头5～6周龄、9～14kg雄性幼猪随机分成4组，分别为LPS组、0．5MAC＋LPS组、1．0MAC＋LPS组、1．3MAC＋LPS组，每组6头。实验动物麻醉后行气管插管，接呼吸机机械通气后，分离左颈外静脉及左颈内动脉，放置中心静脉导管和Picco热稀释导管，用于输注液体及监测血流动力学、血管外肺水（EVLW）、肺泡毛细血管通透性指数（PVPI）、全心舒张末期容积（GEDV）。预处理组先经不同浓度异氟醚预处理30min，1h后，经中心静脉微泵输注20肛g·kg^-1内毒素（LPS），60min内输注完毕。待急性肺损伤形成后观察12h并处死实验动物。实验结束后留取支气管肺泡灌洗液（BALF）检测总蛋白（TP）及肺组织测湿干重比（W／D）。结果：1．3MAC＋LPS组与LPS组相比，PVPI在急性肺损伤形成时（ALl0h）增加（P〈0．05），在急性肺损伤形成后8h（ALI8h）、急性肺损伤形成后12h（ALI12h）显著增加（P〈0．01）；1．0MAC＋LPS组与LPS组相比，肺湿干重比（W／D）及BALF中总蛋白含量减少（P〈0．05）。结论：1．0MAC异氟醚预处理可以降低内毒素诱导的幼猪急性肺损伤肺泡毛细血管通透性。Objective：To investigate the effects of three concentrations of isoflurane pretreatment on alveolar capillary permeability in piglets with endotoxin-induced acute lung injury. Methods..Twenty-four young piglets of 5～6 weeks old, weighing 9～14 kg were anaesthetized, intratracheally intubated and subjected mechanical ventilation. The animals were divided into 4 groups （6 in each group） ： LPS group, 0.5 MAC＋ LPS group, 1.0 MAC＋ LPS group and 1.3 MAC＋ LPS group. After isolation of left external jugular vein and left carotid artery, catheters were placed respectively for infusion fluid and monitoring hemodynamie parameters, extravasvascular lung water （EVLW）, pulmonary vascular permeability index （PVPI）, the global end - diastolic volume （GEDV） using Picco device. After 1 hour pretreated by three different concentrations of isoflurane for 30 min, each animal was received lipopolysaccharide （LPS） 20 μg · kg^-1 by vein infusion for 60 min. Observed 12 hours from the establishment of acute lung injury model, The animals were killed and lungs were processed for measurement of the wet/dry （W/D） lung weight ratio, total protein content in bronchoalveolar lavage fluid （BALF）. Result： Inhalation of 1.3 MAC isoflurune 30 min for pretreatment the PVPI increased at ALI 0 h （P〈0.05）, ALl 8 h, ALI 12 h （P〈0.01） compared with LPS group. In 1.0 MAC ＋ LPS group W/D lung weight ratio and the total protein content in BALF decreased compared with LPS group （P〈0.05）. Conclusion： Inhalation of 1.0 MAC isoflurane 30 min for pretreatment may decrease the permeability of alveolar capillary in piglets with acute lung injury inducecl by endotoxin.

关 键 词：异氟醚 内毒素 急性肺损伤 肺泡毛细血管通透性 

分 类 号：R971.2[医药卫生—药品]