瑞芬太尼对兔油酸性急性肺损伤的影响  

Effects of remifentanil on acute lung injury induced by oleic acid in rabbits

作　　者：杜成[1] 孙思庆[2] 王润丰[1] 徐婷[2] 

机构地区：[1]南京市胸科医院重症医学科,江苏南京210009 [2]东南大学附属中大医院呼吸科,江苏南京210009

出　　处：《东南大学学报（医学版）》2015年第1期40-43,共4页Journal of Southeast University(Medical Science Edition)

基　　金：南京市医学科技发展课题(YKK12130)

摘　　要：目的：探讨瑞芬太尼对兔油酸性急性肺损伤（ ALI ）的影响。方法：选取健康成年雄性新西兰大白兔18只,由东南大学医学院实验动物中心提供,体质量2.5~3.5 kg,随机分为3组（n=6）,即对照组、油酸组和瑞芬太尼组。对照组经30 min静脉输注生理盐水10 ml；油酸组经30 min静脉注射油酸0.1 ml·kg-1；瑞芬太尼组静脉输注瑞芬太尼0.2μg·kg-1·min-1至处死,输注15 min时开始给予油酸,方法同油酸组。各组大白兔分别在输入瑞芬太尼或生理盐水（以下简称给药）前和给药后6 h记录平均动脉血氧分压（ PaO2）,及ELISA法检测血浆细胞黏附分子1（ ICAM-1）、TNF-α及IL-8浓度。给药6 h后处死动物并迅速剖胸取肺脏,肉眼观察肺组织病理改变,留取肺组织标本行电镜观察肺组织超微结构变化和测定湿干质量比。结果：瑞芬太尼组肺组织损伤程度逐渐减轻,明显轻于油酸组,瑞芬太尼能显著降低油酸性ALI兔血浆中ICAM-1、TNF-α及IL-8水平,改善ALI兔肺水肿,从而使PCO2和PaO2均明显改善。结论：瑞芬太尼能有效地抑制血管内皮细胞及肺泡上皮细胞的损伤和炎症细胞浸润,阻滞ALI时失控的炎症反应,其机制可能与抑制ICAM-1、TNF-α及IL-8的表达有关。Objective：To investigate the effects of remifentanil （ RF） on acute lung injury（ ALI） induced by oleic acid in rabbits. Methods：Eighteen healthy male New Zealand white rabbits weighing 2. 5-3. 5 kg were randomly divided into 3 groups （ n=6 each）：control group, oleic acid group and RF group. The animals were anesthetized with intravenous 3% pentobarbital sodium 30 mg·kg-1 , tracheostomized and mechanically ventilated. The carotid artery and jugular vein were cannulated for blood sampling, fluid and drug administration. Oleic acid 0. 1 ml·kg-1 in 10 ml of normal saline （NS） was infused over 30 min in oleic acid group and RF group. RF 0. 2 μg·kg-1· min-1 was infused starting from 15 min before oleic acid administration until the death of the animals. PaO2 and plasma ICAM-1,TNF-αand IL-8 concentration were measured immediately before oleic acid infusion and at 6 h after the end of oleic acid infusion. The animals were killed and the lungs were immediately removed for microscopic examination and determination of W/D lung weight ratio. Results： PaO2 were significantly decreased while W/D ratio were significantly increased in oleic group and RF group as compared with control group. Oleic acid significantly increased plasma ICAM-1,TNF-αand IL-8 concentration and damaged the structure of lung tissue. Remifentanil infusion significantly attenuated the OA-induced changes in a dose-dependent manner. Conclusion：RF has protective effect against acute lung injury induced by oleic acid and inhibition of ICAM-1,TNF-αand IL-8 expression is involved in the mechanism.

关 键 词：哌啶类 油酸 急性肺损伤 新西兰大白兔 

分 类 号：R285.6[医药卫生—中药学] R-33[医药卫生—中医学]