外源性IGF-1预先给药对体外循环大鼠肺损伤的影响  

Effects of pretreatment with exogenous insulin-like growth factors-1 on lung injury in rats undergo-ing cardiopulmonary bypass

作　　者：李健 何苗[2] 谢菲[1] 张琳[1] 窦雪娇[1] 陈淼[3] 张红[1] Li Jian;He Miao;Xie Fei;Zhang Lin;Dou Xuejiao;Chen Miao;Zhang Hong(Department of Anesthesiology, Zunyi Medical College, Zunyi 563003, Chin;Department of Anesthesiology, Affiliated Hospital of Chengdu University, Chengdu 610000, Chin;Department of ICU-2, Affiliated Hospital of Zunyi Medical College, Zunyi 563000, China)

机构地区：[1]遵义医学院麻醉学系,563003 [2]成都大学附属医院麻醉科,610000 [3]遵义医学院附属医院ICU-2,563003

出　　处：《中华麻醉学杂志》2018年第2期219-222,共4页Chinese Journal of Anesthesiology

基　　金：国家自然科学基金（81460074）;贵州省麻醉研究生工作站

摘　　要：目的 评价外源性胰岛素样生长因子-1（IGF-1）预先给药对体外循环（CPB）大鼠肺损伤的影响.方法 SPF级健康成年雄性SD大鼠72只,体重350- 500 g,采用随机数字表法分为4组（n=18）：假手术组（S组）、CPB组、CPB＋左肺缺血再灌注组（LI组）和IGF-1组.S组仅开胸,不进行CPB;CPB组仅建立CPB模型;LI组在CPB模型建立基础上制备左肺缺血再灌注损伤模型;IGF-1组建立CPB＋左肺缺血再灌注损伤模型,并于阻断肺门前10 min和开放肺门即刻静脉注射IGF-1 30μg/kg.分别于术前（T1）、开放肺门后10 min（T2）和术毕时（T3）随机取6只大鼠,经股动脉取血0.5ml行血气分析,计算氧合指数（0I）和呼吸指数（RI）,随后分离血清,采用ELISA法检测血清IL-6、IL-1β和TNF-α浓度.取左上肺组织,HE染色后光镜下观察肺组织病理学结果并进行损伤评分.结果 与T1时比较,CPB组、LI组和IGF-1组T3时OI降低,RI、血清IL-6、IL-1β、TNF-α浓度和肺组织病理学损伤评分升高（P＜0.05）;与S组比较,CPB组、LI组和IGF-1组T3时OI降低,RI、血清IL-6、IL-1β、TNF-α浓度和肺组织病理学损伤评分升高（P＜0.05）;与CPB组比较,LI组T3时OI降低,RI、血清IL-6、IL-1β、TNF-α浓度和肺组织病理学损伤评分升高（P＜0.05）;与LI组比较,IGF-1组T3时OI升高,RI、血清IL-6、IL-1β浓度和肺组织病理学损伤评分降低,血清TNF-α浓度升高（P＜0.05）.结论 IGF-1预先给药可减轻CPB大鼠肺损伤,其机制与抑制炎性反应有关.Objective To evaluate the effects of pretreatment with exogenous insulin-like growth factor-1 （IGF-1） on lung injury in rats undergoing cardiopulmonary bypass （CPB）.Methods Seventy-two SPF healthy male Sprague-Dawley rats,weighing 350-500 g,were divided into 4 groups （n =18 each） using a random number table：sham operation group （group S）,CPB group,CPB plus left lung ischemia-reperfusion group （group LI） and IGF-1 group.The chest was only opened,and the rats underwent no CPB in group S.Only the CPB model was established in group CPB.The model of left lung ischemia-reperfusion injury was established based on the CPB model in group LI.The model of CPB and left lung ischemia-reperfusion injury was established,and IGF-1 30 μg/kg was intravenously injected at 10 min before clamping the hilum of lung and immediately after opening the hilum of lung in group IGF-1.Six rats were selected before operation （T1）,10 min after opening the left hilum （T2） and at the end of operation （T3）,and blood samples were collected from the femoral artery for blood gas analysis.The oxygenation index （OI） and respiratory index （RI） were calculated.Serum was obtained from blood,and the concentrations of interleukin-6 （IL-6）,IL-1β and tumor necrosis factor-alpha （TNF-α） in serum were measured using enzyme-linked immunosorbent assay.The left upper lung tissues were removed for examination of the pathological changes which were scored with a light microscope.Results Compared with the baseline at T1,OI was significantly decreased,and RI,concentrations of IL-6,IL-1β and TNF-α in serum and pathological scores of lung tissues were increased at T3 in CPB,LI and IGF-1 groups （P〈0.05）.Compared with group S,OI was significantly decreased,and RI,concentrations of IL-6,IL-1β and TNF-α in serum and pathological scores of lung tissues were increased at T3 in CPB,LI and IGF-1 groups （P〈0.05）.Compared with group CPB,OI was significantly decreased,and RI,concentrations of IL-6,IL-1β and TNF-

关 键 词：胰岛素样生长因子I 心肺转流术 呼吸窘迫综合征 成人 

分 类 号：R614[医药卫生—麻醉学]