吸入一氧化碳对大鼠脑死亡致肺损伤的影响  

Effects of carbon monoxide inhalation on lung injury induced by brain death in rats

作　　者：金笛[1] 周华成[1] 李文志[1] 潘鹏[1] 丁文刚[1] 

机构地区：[1]哈尔滨医科大学附属第二医院麻醉科,150086

出　　处：《中华麻醉学杂志》2009年第6期536-539,共4页Chinese Journal of Anesthesiology

基　　金：国家自然科学基金资助项目（30571784）

摘　　要：目的评价吸入一氧化碳（CO）对大鼠脑死亡致肺损伤的影响。方法成年雄性Wistar大鼠24只，随机分为3组（n=8），假手术组（SH组）颅内置入Fogarty管，但不诱导脑死亡，吸入40％氧气，持续150min；脑死亡组（BD组）膨胀Fogarty球囊，确认脑死亡后吸入40％氧气，持续120min；脑死亡＋CO组（BDCO组）膨胀Fogarty球囊，确认脑死亡后吸入40％氧气＋0．025％CO混合气，持续120min。于麻醉前、确认脑死亡即刻、吸入CO 30、60、90、120min时行动脉血气分析；于吸入CO 120min时，检测血浆白细胞介素6（IL-6）、肿瘤坏死因子α（TNF—α）和IL-10的浓度；计算肺湿干重比（W／D）；检测肺组织髓过氧化物酶（MPO）活性，行肺组织损伤评分。结果与SH组比较，BD组和BDCO组脑死亡后PaO2／FiO2、BE和pH值下降，血浆IL-6、TNF-α和IL-10的浓度和肺组织损伤评分升高，BD组肺W／D、MPO活性升高（P〈0．05）；与BD组比较，BDCO组脑死亡后PaO2／FiO2、BE、pH值和血浆IL-10浓度升高，肺组织MPO活性、血浆IL-6、TNF—α的浓度和肺组织损伤评分降低（P〈0．05）。结论吸入CO可减轻大鼠脑死亡诱发的肺损伤，其机制可能与CO降低肺组织局部和全身炎性反应有关。Objective To investigate the effects of carbon monoxide （CO） inhalation on lung injury induced by brain death （BD） in rats. Methods Adult male Wistar rats weighing 250-300 g were used in this study. The animals were anesthetized with intraperitoneal pentobarbital sodium 60 mg/kg, tracheostomizcd and mechanically ventilated （VT 10 ml/kg, RR 50 bpm, PEEP 2 cm H2O）. A balloon-tip catheter was placed in the cranium. Twenty-four rats in which Fogarty catheter was successfully placed in the cranium without complication were randomly divided into 3 groups （ n = 8 each） ： group Ⅰ sham operation （group S） ; group Ⅱ BD and group Ⅲ BDCO. BD was induced by increase in intracranial pressure produced by inflating the balloon at the tip of the catheter. In group S the balloon of the catheter was not inflated. The animals inhaled 40% 02 for 150 min. In group BD, BD was induced and confirmed at 30 min after inflation of the balloon. Then 40% O2 was inhaled for 120 min. In group BDCO, 40% O2 and 0.025% CO were inhaled for 120 min after BD was confirmed at 30 min after balloon inflation. At the end of the experiment the animals were killed. Arterial blood samples were obtained for blood gas analysis before anesthesia （basline）, immediately after confirmation of BD, and at 30, 60, 90 and 120 min of CO inhalation. Blood was collected for determination of plasma TNF-α, IL-6 and IL-10 concentrations at 120 min of CO inhalation. The lungs were obtained for determination of W/D lung weight ratio, and MPO activity in the lung tissue and microscopic examination. Lung injury scores were calculated. Results PaO2/FiO2 was stable during the 150 min in group S. Brain death significantly decreased PaO2/FiO2 at 30 rain alter balloon inflation. PaO2/FiO2 was gradually decreasing during the 120 min in group BD. CO inhalation prevented PaO2/FiO2 from decreasing further. W/D lung weight ratio and MPO activity were significantly higher in group BD than in group S and BDCO. The lung injury score （1 = normal, 4 = sever

关 键 词：一氧化碳 脑死亡 肺 

分 类 号：R614[医药卫生—麻醉学]