依达拉奉对肺癌胸腔镜手术中单肺通气相关肺损伤的保护作用  

Protective effect of edaravone on injury of lungs induced by one lung ventilation in lung cancer patients undergoing thorascopic surgery

作　　者：屈亚云[1] 武莉芳[1] 张秀敏[1] 罗磊萍 朱红霞[1] 苏心镜[1] 

机构地区：[1]河北北方学院附属第二医院麻醉科,河北张家口075100

出　　处：《新乡医学院学报》2016年第12期1054-1056,1061,共4页Journal of Xinxiang Medical University

基　　金：张家口市科学技术研究与发展指导计划项目(编号:1521106D)

摘　　要：目的观察依达拉奉在肺癌胸腔镜手术中单肺通气时相关肺损伤的保护作用。方法选择2013年1月至2015年12月于河北北方学院附属第二医院择期行胸腔镜肺叶切除手术的肺癌患者60例,随机将其分为对照组和依达拉奉组,每组30例。依达拉奉组患者于手术前30 min开始静脉滴注依达拉奉30 mg(溶于100 m L生理盐水),30 min内滴注完毕,对照组以同样方式静脉滴注100 m L生理盐水。2组患者分别于切皮前和单肺通气结束时取肘静脉血样,检测血清肿瘤坏死因子-α(TNF-α)、白细胞介素-8(IL-8)水平;于开胸单肺通气开始时、肺叶离断时取肿瘤边缘正常肺组织,测定肺水通道蛋白1(AQP1)、肺水通道蛋白4(AQP4)表达,并对2组患者检测结果进行比较。结果单肺通气结束时2组患者血清TNF-α、IL-8水平较肺通气开始时明显升高(P<0.05);依达拉奉组患者单肺通气结束时血清TNF-α、IL-8水平较对照组明显下降(P<0.05)。与开胸单肺通气时比较,肺叶切除时2组患者肺组织AQP1和AQP4表达明显增高(P<0.05);与对照组比较,依达拉奉组患者肺叶切除时肺组织AQP1和AQP4表达明显降低(P<0.05)。结论依达拉奉预先给药可降低肺癌胸腔镜肺叶切除术单肺通气时TNF-α、IL-8水平,抑制AQP1、AQP4的表达。Objective To observe the protective effect of edaravone on injury of lungs induced by one lung ventilation in lung cancer patients undergoing thorascopic surgery. Methods Sixty lung cancer patients who scheduled for thorascopic pulmonary lobectomy surgery in the Second Affiliated Hospital of Hebei North University from January 2013 to December 2015 were selected and randomly divided into edaravone group and control group,with 30 patients in each group. The patients in edaravone group received intravenous injection of edaravone 30 mg( dissolution in normal saline 100 m L) within 30 min before surgery; the patients in control group was administered normal saline 100 m L in the same manner. Ulnar venous blood samples were taken from all patients before skin incision and at the end of one lung ventilation for detecting the serum levels of tumor necrosis factor-α( TNF-α) and interleukin-8( IL-8). The normal lung tissues of tumor margin were taken when the one lung ventilation was started and the lung lobe was resected to detect the expression of aquaporin 1( AQP1) and AQP4; then the results of the patients were compared between the two groups. Results The levels of TNF-α and IL-8 of patiens in the two groups at the end of one lung ventilation were significantly higher than onset of lung ventilation( P < 0. 05). The levels of TNF-α and IL-8 of patiens in the edaravone group were significantly lower than those in the control group at the end of one lung ventilation( P < 0. 05). The expression of AQP1 and AQP4 of patients in the two groups at the time point of the lung lobe was resected were significantly higher than at the time point of one lung ventilation( P < 0. 05). Compared with control group,the expression of AQP1 and AQP4 of patients in edaravone group were lower at the time point of the lung lobe was resected( P <0. 05). Conclusion Edaravone can reduce the levels of TNF-α,IL-8 and inhibit the expression of AQP1,AQP4 in lung cancer patients undergoing thorascopic pulmonary lobectomy surgery.

关 键 词：依达拉奉 单肺通气 水通道蛋白 肿瘤坏死因子-α 白细胞介素-8 胸腔镜手术 肺损伤 肺癌 

分 类 号：R734.2[医药卫生—肿瘤]