七氟烷后处理对大鼠肺缺血再灌注损伤的影响  

Effects of sevoflurane postconditioning on lung ischemia-reperfusion injury in rats

作　　者：张素品[1] 张加艳[1] 于泳浩[1] 王国林[1] 

机构地区：[1]天津医科大学总医院麻醉科,300052

出　　处：《中华麻醉学杂志》2009年第8期753-756,共4页Chinese Journal of Anesthesiology

摘　　要：目的探讨七氟烷后处理对大鼠肺缺血再灌注（IR）损伤的影响及其可能机制。方法健康SPF级雄性SD大鼠96只，体重270—330g。随机分为4组（n=24）：假手术组（S组）、缺血再灌注组（IR组）、七氟烷预处理组（SPr组）和七氟烷后处理组（SPo组）。采用阻断左肺门45min后再灌注的方法制备大鼠单肺原位IR模型。SPr组吸入七氟烷，呼气末浓度2．1％，30min后制备肺IR模型；SPo组于再灌注前即刻吸入七氟烷30min，呼气末浓度2．1％。分别于再灌注30min、1、2、4h时测定支气管肺泡灌洗液（BALF）肿瘤坏死因子α（TNF—α）、白细胞介素1（IL-1）、IL-6浓度，并进行白细胞分类计数，计算多形核白细胞占白细胞的百分比（PMN百分比），同时测定肺组织TNF-α、IL-1、IL-6含量及细胞凋亡指数，光镜、电镜下观察肺组织病理学结果并行损伤评分。结果与S组比较，IR组肺组织和BALF中TNF-α、IL-1、IL6水平、细胞凋亡指数、白细胞计数、PMN百分比和肺组织损伤评分均升高，Sir组和SPo组肺组织TNF-α、IL-1、IL-6含量升高（P〈0．01）；与IR组比较，SPr组和SPo组上述指标均降低（P〈、0．05或0．01）；SPr组与SPo组各指标差异无统计学意义（P〉0．05）。结论七氟烷后处理可减轻大鼠肺IR损伤，效果与其预处理无差异，其肺保护作用的机制可能与降低肺组织炎性反应，抑制细胞凋亡有关。Objective To investigate the effects of sevoflurane postconditioning on lung ischemia- reperfusion （IR） injury in rats and the mechanism involved. Methods Ninety-six male SD rats weighing 270- 330 g were randomly divided into 4 groups （ n = 24 each） ： sham operation group （ group S ）, group IR, sevoflurane preconditioning group （group SPr）, and sevoflurane postconditioning group （group SPo）. The animals were anesthetized with intraperitoneal 10% chloral hydrate 400 mg/kg, tracheostomized and mechanically ventilated. Lung IR was produced by occlusion of the hilum of the left lung for 45 min and then it was unclamped for reperfusion. In group SPr, sevoflurane was inhaled at the end-tidal concentration of 2.1% 30 rain before lung ischemia. In group SPo, sevoflurane was inhaled at the end-tidal concentration of 2.1% immediately before reperfusion. Six rats from each group were sacrificed at 30 min, 1 h, 2 h, and 4 h of reperfusion respectively. The TNF-α, IL-1 and IL-6 concentrations, and WBC count in broncho-alveolar lavage fluid （BALF） were determined. The percentage of PMN in WBC was calculated. The lungs were removed for determination of the content of TNF-α, IL-1 and IL-6 in the lung tissues and microscopic examination. The apoptosis index （AI） was calculated by TUNEL assay. Lung injury was scored. Resulls The levels of TNF-α, IL-1 and IL-6 in lung tissues and BALF, AI, WBC count, percentage of PMN, and lung injury scores were significantly higher in group IR than in group S （P 〈 0.01）. The content of TNF-α, IL-1 and IL-6 in lung tissues was significantly higher in group SPr and SPo than in group S （P 〈 0.01）. The indices mentioned above were all significantly lower in group SPr and SPo than in group IR （P 〈 0.05 or 0.01） . No significant differences were found in the indices mentioned above between group SPr and SPo （ P 〉 0.05）. Conclusion Scvoflurane postconditioning can protect the lungs from IR injury by decreasing the inflammatory reaction and inhibi

关 键 词：麻醉药 吸入 再灌注损伤 肺 缺血后处理 

分 类 号：R96[医药卫生—药理学]