亚甲蓝预防肠缺血再灌注后肺损伤的实验研究  

Methylene blue prevents lung injury after intestinal ischemia reperfusion in rabbit

作　　者：吴多志[1] 梁敏[1] 陈揭晓[1] 王俊博[1] 

机构地区：[1]海南省人民医院麻醉科,海南海口570311

出　　处：《海南医学》2009年第6期7-10,共4页Hainan Medical Journal

基　　金：海南省自然科学基金立项课题(编号:808204)

摘　　要：目的探讨亚甲蓝对急性肺损伤的保护作用及其可能机制。方法成年健康SD家兔24只,雄雌不限。麻醉后,开腹游离肠系膜前动脉,制备肠缺血再灌注模型。按双盲法随机分为3组,每组8只,即对照组(S组),再灌注损伤组(I/R组),亚甲蓝保护组(MB组):于动脉松夹即刻分别按10mg/kg静脉给MB。分别测定基础值、松夹前、再灌注2h血中丙二醛(MDA)、血清白细胞介素-8(IL-8)、肿瘤坏死因子-α(TNF-α)值。肺组织中超氧阴离子(O2-)、超氧化物歧化酶(SOD)、过氧化氢酶(CAT)和黄嘌吟氧化酶(XOD)值。全程监测平均动脉压(MAP)、心率(HR)、呼吸频率(R)变化,并记录以上3个时点的值。结果肠缺血期各组MAP无显著变化;再灌注2h后,I/R组MAP较基础值明显下降,从基础的(92±17)mm-Hg降至(62±6.7)mmHg(P<0.01);而MB组再灌注前后MAP有轻度改变,但无统计学意义。S组血中MDA实验前后变化无统计学意义。与S组比较,再灌注2h后,I/R组肺组织中O2-及血中MDA含量显著增高,血中MDA由基础值(1.75±1.0)mmol·gprot-1,增至(3.67±1.47)mmol·gprot-1(P<0.01);同时CAT也有显著增加迹象(P<0.01)。而MB组再灌注前后血中MDA增加无统计学意义。各组肺组织SOD和XOD活性差异无统计学意义。与S组比较,I/R组血清TNF-α、IL-8浓度明显升高(P<0.01);MB组虽有一定程度升高,但无统计学意义。MB组与I/R组比较,血清TNF-α、IL-8浓度则明显降低(P<0.05)。结论亚甲蓝可减轻肠缺血再灌注兔肺损伤。可能与其抑制氧自由基的生成及IL-8、TNF-α等前炎症因子过度释放,从而减轻了炎性反应有关。Objective To investigate the protective effect and its mechanisms of methylene blue （MB） on pulmonary injury after ischemia reperfusion （I/R） , and the mechanism of MB. Methods Twenty four rabbits were randomly divided into three groups ： sham operated group （ group S） underwent an identical laparotomy except for the superior mesenteric artery （SMA） occlusion. The I/R group and MB treated group was produced by occluding the SMA for 1 hr, reperfusing for 2hrs respectively. MB group was received 1% MB by 10mg/kg before immediately removed the clip, I/R group was administered with saline. The model of intestinal I/R was developed by occluding the SMA. The serum IL - 8, TNF - α concentration, the level of MDA, the activities of SOD, XOD, CAT and O2 ^- in lung tissue were determined at the end of the experiment. Results The mean artary pressure （MAP） was significantly lower in I/R group than that in MB group after intestinal I - R （ P 〈 0.01 ）, but MAP did not significantly change in MB group. The level of O ^- 2 and MDA in the lung tissue were markedly increased in I - R group than that of in the S group （ P 〈0.01 ）, but no significant change in MB group. The activities of SOD and XOD in lung tissue did not significantly change in all groups. The serum concentration of IL - 8 and TNF - α were significantly higher in group I/R than that in group S （ P 〈 0.01 ） , but no significant change in MB group compared to group S. The serum concentration of IL - 8 and TNF - α were significantly lower in MB group than that in I - R group （ P 〈 0.01 ）. Conclusion MB can reduce lung injury after intestinal I - R. The mechanisms may be associated with inhibiting the generation of OFR and decreasing inflammatory response.

关 键 词：亚甲蓝 肠缺血再灌注 氧自由基 肺损伤 保护 

分 类 号：R-33[医药卫生]