右美托咪啶对内毒素致大鼠急性肺损伤的保护作用  

Protective effect of dexmedetomidine on endotoxin-induced acute lung injury in rats

作　　者：孟志鹏[1] 胡四平[1] 童飞[1] 龚浩杰[1] 刘静 

机构地区：[1]湖州市中心医院麻醉科,313000 [2]湖州市妇幼保健院麻醉科

出　　处：《中华创伤杂志》2017年第6期560-564,共5页Chinese Journal of Trauma

基　　金：湖州市重点公益类项目（2015GZ17）

摘　　要：目的探讨右美托咪啶（DEX）对急性肺损伤（ALI）的保护性作用。方法清洁级健康成年雄性SD大鼠48只，按随机数字表法分为4组：对照组、内毒素（LPS）组、DEX治疗组、DEX预处理组，每组12只。采用股静脉注射LPS 8 mg/kg制备大鼠ALI模型。DEX治疗组在LPS注射0.5 h后2 min内股静脉注射DEX 50 μg/kg，随后以5 μg·kg－1·h－1泵入，直到实验结束。DEX预处理组在LPS注射前0.5 h 2 min内股静脉注射DEX 50 μg/kg，同样以5 μg·kg－1·h－1泵入，直到实验结束。对照组注入等量等渗盐水。静脉注射LPS或等渗盐水6 h后，颈动脉放血致死。取右肺上叶，光镜下观察病理结果并进行弥漫性肺泡损伤标准（DAD）评分；取右肺中叶，计算肺湿/干重（W/D）值；采集颈动脉血样测定肿瘤坏死因子（TNF－α）、白细胞介素－6（IL－6）水平；左肺支气管灌洗，采集肺泡灌洗液（BALF），测定TNF－α、IL－6、总蛋白水平。结果静脉注射LPS后引起肺组织损伤性变化，与对照组比较，其余三组病理损伤均明显，DAD评分升高（P〈0.05）；与LPS组比较，DEX治疗组与DEX预处理组的病理损伤明显减轻，DAD评分降低（P〈0.05）；与DEX治疗组比较，DEX预处理组病理损伤减轻，DAD评分降低（P〈0.05）。与对照组比较，其余三组W/D值明显增加（P〈0.05）；与LPS组比较，DEX治疗组、DEX预处理组W/D值明显降低（P〈0.05）；与DEX治疗组比较，DEX预处理组W/D值明显降低（P〈0.05）。与对照组比较，其余三组TNF－α、IL－6均升高（P〈0.05）；与LPS组比较，DEX治疗组、DEX预处理组TNF－α、IL－6均降低（P〈0.05）；与DEX治疗组比较，DEX预处理组TNF－α、IL－6均降低（P〈0.05）。与对照组比较，LPS组、DEX治疗组BALF中的TNF－α、IL－6升高（P〈0.05），而DEX预处理组差异无统计学意义（P〉0.05）；与LPS组比较，DEX治疗组、DEX预处理组BALObjective To investigate the protective role of dexmedetomidine in rats with endotoxin-induced acute lung injury （ ALI ）. Methods Forty-eight adult male SD rats were divided into four groups （n = 12 each） according to the random number table： control group, lipopolysaccharide （LPS） group, dexmedetomidine （DEX） treatment group and DEX pretreatment group. ALl was induced in rats by femoral intravenous injection of LPS （ 8 mg/kg）. Rats in DEX treatment group was given DEX （50 μg/kg） for 2 minutes via the femoral intravenous injection 0.5 hour after LPS injection, followed by maintenance pump injection of DEX （5 μg · kg-1· h - 1）. Analogously, rats in DEX pretreatment group was given DEX （50 μg/kg） for 2 min via the femoral intravenous injection 0. 5 hour before LPS injection, followed by maintenance pump injection of DEX （5 μg · kg-1· h-1 ）. By contrast, control group received the same amount of normal saline intravenously. All rats were sentenced to death and their carotid blood samples were collected 6 hours after all injections. Superior lobe of the fight lung was examined under light microscope and the histologic findings were tested using the difusse alveolar damage （DAD） score. Middle lobe of the right lung was used to calculate the lung tissue wet/dry weight （W/D） ratio. Samples of collected carotid blood were taken to measure levels of tumor necrosis factor （TNF） -α and interleukin （IL）-6. Bronchoalveolar lavage fluid （BALF） obtained from bronchoalveolar lavage was collected to measure levels of TNF-α and IL-6. Results Lung tissue injury was obvious after LPS injection and DAS score was improved as well. However DEX therapy reduced the lung damage as well as the DAD score, especially obvious in DEX pretreatment group （ P 〈 0.05 ）. W/D ratio was obviously increased in other three groups compared to control group, but further comparison showed that W/D ratio was lowered in DEX treatment and pretreatment groups compared to LPS group, espe

关 键 词：急性肺损伤 右美托咪啶 内毒素血症 

分 类 号：R614[医药卫生—麻醉学]