七氟醚对感染性休克大鼠全身炎性反应及心肺功能的影响  

Effects of sevoflurane on systemic inflammatory response and cardiopulmonary function in septic shock rats

作　　者：胡柳[1] 景亮[1] 

机构地区：[1]东南大学附属中大医院麻醉科,南京市210009

出　　处：《中华麻醉学杂志》2009年第6期553-557,共5页Chinese Journal of Anesthesiology

摘　　要：目的评价七氟醚对感染性休克大鼠全身炎性反应及心肺功能的影响。方法清洁级SD大鼠32只，体重250～300g，月龄8～10月，雌雄各半，随机分为4组（n=8）：假手术组（S组）仅开腹，不行盲肠结扎穿孔（CLP）；感染性休克组（CLP组）采用CLP法建立感染性休克模型；七氟醚Ⅰ组（SEV1组）感染性休克后1h时吸入2．4％七氟醚30min；七氟醚Ⅱ组（SEV2组）感染性休克后3h时吸入2．4％七氟醚30min。于感染性休克后1、3、5h时记录MAP和HR，并采集动脉血样1．5ml，取0．3ml血样行血气分析，剩余1．2ml血样检测血浆肿瘤坏死因子α（TNF-α）、白细胞介素1（IL-1）、丙二醛（MDA）及一氧化氮（NO）的浓度。于感染性休克后5h时测定心功能，记录心脏左心室舒张末期内径（LVEDD）、左心室收缩末期内径（LVESD）、左心室短轴缩短率（LVFS）和心输出量（CO）。心功能测定后处死动物，取肺组织，计算肺湿干重比（W／D），测定伊文氏兰（EB）含量；取心、肺、肝、肾组织，检测NF—κB活性。结果与S组比较，CLP组、SEV1组和SEU组MAP降低，HR增快，LVEDD、LVESD、LVFS、CO、pH值、PaO2和PaCO2降低，肺W／D、EB含量、血浆TNF-α、IL-1、MDA和NO的浓度增加，心、肺、肝、肾组织的NF—κB活性升高（P〈0．05）。与CLP组和SEV2组比较，SEV．组心、肺、肝、肾组织的NF—κB活性和血浆TNF-α、IL-1、MDA和NO的浓度降低（P〈0．05），其余各指标差异无统计学意义（P〉0．05）。结论感染性休克后1h大鼠吸入2．4％七氟醚30min可抑制全身炎性反应，但抑制程度较低，不足以改善心肺功能。Objective To investigate the effects of sevoflurane on the systemic inflammatory response and cardiopuhnonary function in septic shock rats. Methods Thirty-two SD rats, 8-10 months old, weighing 250- 300 g, were randomly divided into 4 groups （ n = 8 each） ： sham operation group （group S）, cecal ligation and puncture （CLP） induced septic shock group （group CLP） , sevoflurane Ⅰ group （group SEV1 ） and sevoflurane Ⅱ group （group SEV2 ）. The abdomen was opened but CLP was not performed in group S. The septic shock was induced by CLP as described by Baker et al. Group SEV1 and SEV2 inhaled 2.4% sevoflurane for 30 min at 1 h and 3 h after the successful establishment of the model respectively. At 1, 3 and 5 h after septic shock, MAP and HR were recorded and arterial blood samples were taken for blood gas analysis and determination of plasma concentrations of TNF-α, IL-1, MDA and NO. The left ventricular end-diastolic diameter （LVEDD）, left ventricular end-systolic diameter （LVESD）, left ventricular fractional shortening （LVFS） and cardiac output （CO） were also detected 5 h after septic shock. The animals were killed after the detection of cardiac function. The lungs were removed for determination of W/D lung weight ratio and Evans blue （EB） content. The tissues from the heart, lung, liver and kidney were taken for detection of NF-κB activity by clectrophoretic mobility shift assay （EMSA） .Results MAP was significantly lower, HR higher, LVEDD, LVESD, LVFS, CO, pH value, PaO2 and PaCO2 lower, and W/D lung weight ratio, EB content, plasma concentrations of TNF-α, IL-1, MDA and NO, and NF-κB activity in the heart, lung, liver and kidney tissues higher in group CLP, SEV1 and SEV2 than in group S （P 〈 0.05）. NF-κB activity in the heart, lung, liver and kidney tissues and plasma concentrations of TNF-α, IL-1, MDA and NO were significantly lower in group SEV1 than in group CLP and SEV2 （ P 〈 0.05）, but no significant differences were found in the other in

关 键 词：麻醉药 吸入 休克 炎症 呼吸功能试验 心脏功能试验 

分 类 号：R459.7[医药卫生—急诊医学]