右美托咪定对急性胰腺炎肺损伤大鼠的保护作用  

Protective effect of dexmedetomidine against lung injury in rats with acute pancreatitis

作　　者：张清[1] 马思杰[1] 沈承澜[2] 沈韩雄[1] 曲立哲[1] 王召红 严赟[1] 

机构地区：[1]上海中医药大学附属市中医医院麻醉科,上海200071 [2]上海中医药大学附属市中医医院普外科,上海200071

出　　处：《上海医学》2015年第9期714-718,I0002,共6页Shanghai Medical Journal

摘　　要：目的观察右美托咪定（Dex）对急性胰腺炎（AP）大鼠血清炎性细胞因子水平、肺损伤、胰腺组织损伤的影响。方法32只健康成年雄性Sprague-Dawley（SD）大鼠，清洁Ⅱ级，体重190～230g，应用随机数字法分为4组，每组8只：假手术组、模型组、Dex低剂量组（2#g／kg）、Dex高剂量组（10ug／kg）。Dex均与0．9％氯化钠溶液配成10mL溶液。模型组、Dex低剂量组、Dex高剂量组采用5％牛磺胆酸钠（1mL／kg）逆行胰胆管注射法制作大鼠AP相关肺损伤模型。Dex低剂量组和Dex高剂量组在建立AP模型后即刻于大鼠尾静脉应用微量注射泵持续注射Dex10mL共15min，假手术组和模型组经微量注射泵注射0．9％氯化钠溶液10mL共15min。造模后4、12h，测定大鼠的血清TNF-α、IL-6和淀粉酶水平。造模后12h，将存活的大鼠放血致死，计算右上肺湿重与干重的比值（W／D值）；取右下肺在光学显微镜下观察肺组织病理学变化，进行肺损伤评分；取胰腺组织在光学显微镜下观察病理学变化，进行胰腺组织损伤评分。结果模型组有2只大鼠在造模后4～12h死亡。模型组、Dex低剂量组、Dex高剂量组造模后4和12h的血清TNF-α、IL-6、淀粉酶水平均显著高于假手术组同时间点（P值均〈0．05）。模型组、Dex低剂量组、Dex高剂量组造模后12h的血清IL-6水平均显著高于同组造模后4h（P值均〈O．05），模型组造模后12h的血清TNF-α水平显著高于同组造模后4h（P〈0．05）。Dex低剂量组和Dex高剂量组造模后4和12h的血清TNF-a、IL-6水平均显著低于模型组同时间点（P值均〈0．05）。Dex高剂量组造模后12h的血清TNF-α水平显著低于Dex低剂量组同时间点（P〈0．05）。模型组、Dex低剂量组、Dex高剂量组组间同时间点和组内不同时间点间血清淀粉酶水平的差异均无统计学意义（P值均〉0．05）。模型组、Dex低剂量组、Dex高剂量组�Objective To investigate the effects of dexmedetomidine on serum inflammatory factors and injury of lungs in acute pancreatitis(AP)rats.Methods Thirty-two healthy male Sprague-Dawley(SD)rats,weighing 190-230 g,were randomly divided into 4 groups(n=8):sham operation group(group C),model group(group M),small-dose dexmedetomidine group(group D1,2μg/kg)and large-dose dexmedetomidine group(group D2,10μg/kg).AP models were established by injecting 5% sodium taurocholate(1mL/kg)into the biliopancreatic duct in group M,D1 and D2.Dexmedetomidine(10mL)was given by micro-injection pump within15 minutes after modeling in group D1 and D2,and equal volume of normal saline was given in group C and M.Serum tumor necrosis factor-alpha(TNF-α),interleukin-6(IL-6)and amylase levels were measured at 4h and 12h after modeling.Then survival rats were sacrificed,and wet to dry weight ratio(W/D)of lung was detected and pathological changes of lung and pancreatic tissues were observed under light microscope.Results Two rats died in group M 4-12h after modeling.Serum TNF-α,IL-6 and amylase concentrations at 4h and 12 hafter modeling in group M,D1 and D2 were significantly higher than those in group C(all P<0.05).Serum IL-6 level at 12 h after modeling was significantly higher than those at 4h after modeling in group M,D1 and D2(all P<0.05).Serum TNF-α at 12 hafter modeling was significantly higher than that at 4hafter modeling in group M(P<0.05).Serum TNF-α and IL-6 levels at 4h and 12h after modeling in group D1 and D2 were significantly lower than those in group M(all P<0.05).Serum TNF-α at 12 h after modeling in group D2 was significantly lower than that in group D1(P<0.05).There were no significantly differences in serum amylase concentration between groups at any time point(all P>0.05).The W/D ratios of lung in group M,D1 and D2 were significantly higher than that in group C(all P<0.01),while the W/D of lung in group D2 was significantly lower than that in group M(P<0.05).Compared with group M,more pathologic damages of lung we

关 键 词：右美托咪定 急性胰腺炎 肺损伤 炎性细胞因子马 

分 类 号：R614[医药卫生—麻醉学]