静脉输注利多卡因对脓毒症大鼠急性肺损伤时肺换气功能的影响  

Effect of intravenous infusion of lidocaine on pulmonary gas exchange function during acute lung injury in septic rats

作　　者：徐桂萍[1] 陈雪莹 张宇轩[1] 麦丽帕特·伊力艾克拜尔 Xu Guiping;Chen Xueying;Zhang Yuxuan;Malipate Yiliaikebaier(Department of Anesthesiology,People′s Hospital of Xinjiang Uygur Autonomous Region Xinjiang Clinical Research Center for Anesthesia Management,Urumqi 830000,China;Graduate School of Xinjiang Medical University,Urumqi 830000,China)

机构地区：[1]新疆维吾尔自治区人民医院麻醉科,新疆麻醉管理临床医学研究中心,乌鲁木齐830000 [2]新疆医科大学研究生学院,乌鲁木齐830000

出　　处：《中华麻醉学杂志》2023年第2期221-224,共4页Chinese Journal of Anesthesiology

摘　　要：目的评价静脉输注利多卡因对脓毒症大鼠急性肺损伤时肺换气功能的影响。方法清洁级健康雄性SD大鼠30只,2~3月龄,体质量220~280 g,采用随机数字表法分为3组(n=10):对照组(C组)、脓毒症组(S组)和利多卡因组(L组)。S组和L组以腹腔注射LPS 10 mg/kg的方法制备脓毒症大鼠急性肺损伤模型,C组注射等量生理盐水,L组注射LPS后1 min时尾静脉注射负荷剂量利多卡因10 mg/kg,再以10 mg·kg^(-1)·h^(-1)的速率持续输注3 h,C组和S组以等量生理盐水替代。注射LPS后24 h时处死大鼠,腹主动脉采血行血气分析并计算氧合指数(OI)、肺泡动脉氧分压差(A-aDO_(2))及呼吸指数(RI),随后立即开胸取左肺组织,采用ELISA法测定TNF-α、血红素氧合酶-1(HO-1)和活性氧(ROS)水平,取右上肺组织,光镜下观察肺泡结构及肺水肿情况,取右下肺组织透射电镜下观察血管内皮结构。结果与C组比较,S组和L组A-aDO_(2)、RI、TNF-α、HO-1和ROS水平升高,PaO_(2)和OI降低,PaCO_(2)差异无统计学意义(P>0.05);与S组比较,L组PaO_(2)、OI和HO-1升高,A-aDO_(2)、RI、TNF-α和ROS水平降低(P<0.05),PaCO_(2)水平差异无统计学意义(P>0.05)。L组肺组织病理学损伤较S组减轻。结论静脉输注利多卡因可改善脓毒症大鼠急性肺损伤时肺换气功能。Objective To evaluate the effect of intravenous infusion of lidocaine on pulmonary gas exchange function during acute lung injury in septic rats.Methods Thirty clean-grade healthy male Sprague-Dawley rats,aged 2-3 months,weighing 220-280 g,were divided into 3 groups(n=10 each)using a random number table method:control group(C group),sepsis group(S group)and lidocaine group(L group).Model of acute lung injury in septic rats was prepared by intraperitoneal injection of LPS 10 mg/kg in S and L groups,the equal volume of normal saline was injected in group C,lidocaine was injected at a loading dose of 10 mg/kg via the tail vein at 1 min after LPS injection and then continuously infused for 3 h at a rate of 10 mg·kg^(-1)·h^(-1),and the equal volume of normal saline was given instead in C and S groups.Rats were sacrificed at 24 h after LPS injection,blood samples from the abdominal aorta were collected for blood gas analysis,and the oxygenation index(OI),alveolar-arterial oxygen difference(A-aDO_(2))and respiratory index(RI)were calculated.Then the chest was immediately opened,and the left lung tissues were then immediately removed to determine the levels of tumor necrosis factor-α(TNF-α),heme oxygenase-1(HO-1)and reactive oxygen species(ROS)(by enzyme-linked immunosorbent assay).The right upper lung tissues were removed for microscopic examination of the alveolar structure and pulmonary edema with a light microscope.The right lower lung tissues were also removed to observe the vascular endothelial structure with a transmission electron microscope.Results Compared with group C,the levels of A-aDO_(2),RI,TNF-α,HO-1 and ROS were significantly increased,the PaO_(2) and OI were decreased(P<0.05),and no significant change was found in PaCO_(2) in group S and group L(P>0.05).Compared with group S,the PaO_(2),OI and HO-1 were significantly increased,the levels of A-aDO_(2),RI,TNF-αand ROS were decreased(P<0.05),and no significant change was found in PaCO_(2) levels in group L(P>0.05).The pathological damages of the lung

关 键 词：利多卡因 脓毒症 肺换气 急性肺损伤 

分 类 号：R459.7[医药卫生—急诊医学] R563[医药卫生—治疗学]