克拉霉素对体外循环肺损伤的保护作用  

Protective effect of clarithromycin on lung injury after cardiopulmonary bypass

作　　者：范祥明[1] 刘迎龙[1] 王强[1] 于存涛[1] 魏波[1] 

机构地区：[1]中国医学科学院阜外心血管病医院先心病研究室,北京100037

出　　处：《中华实验外科杂志》2004年第4期466-468,共3页Chinese Journal of Experimental Surgery

基　　金：国家自然科学基金资助项目 (30 1 70 931 )

摘　　要：目的　采用体外循环 (CPB)动物模型观察克拉霉素对CPB所致肺损伤的保护作用。方法　将 12只绵羊随机分为 2组。A组 ,低分子右旋糖酐肺动脉灌注 ;B组 ,低分子右旋糖酐 +克拉霉素肺动脉灌注。建立CPB后经肺动脉灌注肺保护液 ,CPB90min后撤离CPB。观察呼吸循环功能 ,检测血浆炎症因子和细胞因子浓度 ,并观察肺组织形态学改变。结果　肺保护组气道峰压 (18.8± 1.0 )cmH2 O和肺血管阻力 (10 2 .2± 14 .4)dyne·s·cm-5均低于对照组 (2 1.5± 1.3 )cmH2 O、(2 .6±47.1)dyne·s·cm-5(P <0 .0 1) ,保护组血浆髓过氧化物酶 [MPO ,(0 .0 15± 0 .0 0 6)U/L]、丙二醛 [MDA ,(2 .2 1± 0 .66) μmol/L]和乳酸脱氢酶 [LDH ,(63 2 6± 813 )U/L]均低于对照组(0 .0 2 9± 0 .0 0 7)U/L、(5 .48± 1.91) μmol/L、(10 3 0 8± 2 5 3 3 )U/L(P <0 .0 5 ) ,保护组血浆白介素 8(IL 8) (0 .2 1± 0 .0 4) μg/L和肿瘤坏死因子 [TNF ,(1.0 0± 0 .13 ) μg/L]低于对照组 (0 .5 7± 0 .17) μg/L、(1.5 5± 0 .3 7) μg/L(P <0 .0 5 ) ,形态学观察表明保护组肺损伤较对照组轻。结论　克拉霉素能抑制CPB带来的各种炎症反应 ,减轻CPB所造成的肺脏损伤。ObjectiveTo observe the protective effect of clarithromycin on lung injury after cardiopulmonary bypass(CPB).MethodsTwelve adult sheeps were randomly divided into two groups.Pulmonary artery was clamped after CPB was established and the lungs were perfused with 4 ℃ low molecular weight dextran solution in control group ( n =6) and 4 ℃ low molecular weight dextran solution with clarithromycin in protective group ( n =6).The bypass was withdrawn after 90 min.Respiratory functions were recorded during CPB and some inflammatory factors were measured.Lung biopsies were also performed after operation.Results Peak airway pressure (18.8±1.0) and pulmonary vascular resistance (102.2±14.4) were lower in protective group than in control group (21.5±1.3 and 202.6±47.1 respectively,P <0.01).The plasma levels of myeloperoxidase (MPO) (0.015±0.006),malondialdehyde (MDA) (2.21±0.66) and lactate dehydrogenase (LDH) (6 326±813) in protective group were lower than those in control group (0.029±0.007,5.48±1.91,10 308±2 533,P <0.05).The plasma interlukin-8 (IL-8) (0.21±0.04) and tumor necrosis factor (TNF) (1.00±0.13) in protective group were higher than in control group (0.57±0.17,1.55±0.37,P <0.05).Histologic analyses showed intraalveolar hemorrhage and neutrophil accumulation in control groups.ConclusionClarithromycin can alleviate lung injury by inhibition of inflammatory responses caused by CPB.

关 键 词：克拉霉素 体外循环 肺损伤 保护作用 

分 类 号：R96[医药卫生—药理学]