异氟烷对大鼠急性脊髓损伤后神经源性肺水肿的影响  

Influence of isoflurane on neurogenic pulmonary edema in acute spinal cord injured rats

作　　者：张劭博[1] 纪瑞华[1] 邹最[1] 石学银[1] 林庆录[2] 

机构地区：[1]第二军医大学附属长征医院麻醉科,上海市200003 [2]解放军第88医院麻醉科,山东泰安271000

出　　处：《中国矫形外科杂志》2009年第8期617-620,共4页Orthopedic Journal of China

基　　金：国家自然科学基金项目资助(编号:30772092)

摘　　要：[目的]探讨吸入异氟烷的大鼠急性脊髓损伤过程中血流动力学变化及损伤后肺组织的病理改变。[方法]成年雄性SD大鼠60只,体重280～330g,随机分为水合氯醛组、1.5%异氟烷组和3%异氟烷组。在T8水平球囊扩张造成脊髓压迫,术中监测大鼠的血压、心率,压迫结束10min后处死大鼠,取肺组织称湿、干重,计算湿干重之比;通过大体解剖和光学显微镜观察肺组织的病理变化。[结果]所有进行脊髓压迫的大鼠血压均高于术前基础值(P<0.05),心率均低于术前基础值(P<0.05),1.5%异氟烷组在脊髓压迫过程中的血压上升明显高于水合氯醛组和3%异氟烷组(P<0.05),心率较基础值下降则大于水合氯醛组和3%异氟烷组(P<0.05),水合氯醛组与3%异氟烷组的血压、心率变化差异不显著(P>0.05);1.5%异氟烷组大鼠肺水肿程度较重,肺的湿干重之比较水合氯醛组、3%异氟烷组高,有显著差异(P<0.05),水合氯醛组与3%异氟烷组差异不显著(P>0.05)。[结论]使用1.5%异氟烷麻醉的大鼠急性脊髓损伤后肺水肿的发生速度快、严重程度高,可能与难以抑制交感神经的过度兴奋有关,因此在临床上应尽量避免单纯长时间吸入1.5%异氟烷,以防病人术后肺水肿的发生。[ Objective] To investigate the changes of the hemodynamics and pulmonary histopathology in acute spinal cord injured rats during isoflurane inhalation. [ Method ] Sixty male SD rats with body weights of 300 - 330 g were divided into 3 groups： chloral hydrate group, 1.5% isoflurane group and 3% isoflurane group. Epidural balloon compression of the Ts spinal cord was performed. Blood pressure and heart rate were monitored during surgery. All animals were sacrificed 10 min after being compressed. The author harvested the lung and recorded lung wet/dry weight ratios（W/D） to assess lung injury severity,and observed the changes of the pulmonary pathology. [ Result] Blood pressure in all animals was higher than that of the baseline during the spinal cord injury, but the heart rate was lower than that of the baseline （ P 〈 0.05 ）. Rats from 1.5 % isoflurane group had significantly higher blood pressure and lower heart rate than rats from the 3% group and chloral hydrate groap（P 〈0.05）. No significant difference was found between 3% group and hydrate group（ P 〉 0.05 ）. Rats from the 1.5% isoflurane group exhibited severe neurogenic pulmonary edema. The W/D in 1.5% group was significantly higher than those in the other two groups（ P 〈 0. 05 ）. [ Conclusion ] 1.5 % isoflurane can promote the development of neurogenic pulmonary edema in rats with a compressed spinal cord, which may be due to the uninhibited severe systemic sympathetic over excitation.

关 键 词：脊髓损伤 神经源性肺水肿 异氟烷 大鼠 

分 类 号：R96[医药卫生—药理学]