参麦注射液对单肺通气患者肺损伤的保护作用  

Protective effect of shenmai injection on mechanical ventilation associated lung injury in patients with one-lung ventilation

作　　者：陈菲菲[1] 钱家树 王良荣[1] 金立达[1] 熊响清[1] 

机构地区：[1]温州医科大学附属第一医院麻醉科 [2]浙江省台州市中心医院麻醉科

出　　处：《中国临床药理学与治疗学》2015年第2期199-202,207,共5页Chinese Journal of Clinical Pharmacology and Therapeutics

基　　金：浙江省医药卫生科技计划(2013KYA131);温州市科技局科研基金资助项目(Y20130185)

摘　　要：目的:探讨参麦注射液对单肺通气患者肺损伤的保护作用。方法:择期拟全麻复合连硬下行肺叶切除术的患者40例,随机分为两组:对照组(C组,n=20)和参麦组(S组,n=20)。S组患者麻醉前10min将参麦注射液0.5mL/kg加入100mL生理盐水静脉滴注完毕,C组则使用同等量的生理盐水。分别于麻醉前(T0)、单肺通气后30min(T1)、60min(T2)、90min(T3)、120min(T4)时抽取桡动脉血和混合静脉血做血气分析,并计算肺泡动脉氧压差(A-aDO2)和肺分流率(Qs/Qt)。同时抽取桡动脉血3mL迅速离心,测定血浆中超氧化物歧化酶(SOD)、丙二醛(MDA)、TNF-α、IL-6及IL-10浓度。结果:与T0比较,C组T1-4时Qs/Qt、A-aDO2均升高(P<0.05),S组Qs/Qt、A-aDO2仅T4时升高(P<0.05)。与C组比较,S组T1-4时Qs/Qt、A-aDO2均降低(P<0.05)。与T0比较,C组T1-4时TNF-α、IL-6和IL-10均升高(P<0.05),S组TNF-α、IL-6和IL-10仅T4时升高(P<0.05)。与C组比较,S组T1-4时Qs/Qt、A-aDO2、TNF-α、IL-6和IL-10均降低(P<0.05)。结论:参麦注射液预处理能有效抑制单肺通气后的氧化应激反应和TNF-α、IL-6、IL-10等炎症因子释放,改善肺换气功能,对单肺通气引起的肺损伤具有保护作用。AIM： To study the protective effect of shenmai injection on mechanical ventilation associated lung injury in patients with onelung ventilation.METHODS：40patients scheduled for pulmonary lobectomy were divided to two groups：group C（n=20）and group S（n=20）.0.5mL/kg shenmai injection were given to each patient in group S,while equivalent saline to those in group C.Immediately before anesthesia induction（T0）,30 min（T1）,60 min（T2）,90min（T3）and 120min（T4）after onelung ventilation,radial and mixed venous blood samples were collected for blood gas analysis and calculation of the value of A-aDO2 and Qs/Qt.Meanwhile,3mL radial blood were extracted to detect the levels of MDA,SOD,TNF-α,IL-6and IL-10 in plasma.RESULTS：Compared with T0,the value of Qs/Qt,A-aDO2,TNF-α,IL-6and IL-10 were increased in group C on T1-4（P〈0.05）.Similar changes were presented at T4 in group S.Compared with group C,the value of Qs/Qt,A-aDO2,TNF-α,IL-6 and IL-10 were decreased in group S on T1-4（P〈0.05）.CONCLUSION：Pretreatment with shenmai injection has protective effect on mechanical ventilation associated lung injury in patients undergoing one-lung ventilation.

关 键 词：单肺通气 参麦注射液 SOD MDA TNF-α IL-6 IL-10 

分 类 号：R287[医药卫生—中药学] R614[医药卫生—中医学]