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七氟醚和丙泊酚对家兔肺缺血/再灌注损伤保护作用的对比研究
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摘要
目的:通过建立在体家兔肺缺血再灌注组模型,观察并比较七氟醚和丙泊酚对家兔肺缺血/再灌注损伤的保护作用。
     方法:参照改良的Eppinger方法建立在体家兔肺缺血再灌注损伤模型,将40只健康家兔,随机分为4组(n=10),即:对照组(A组),仅行开胸180MIN;肺缺血/再灌注组(B组),阻断左肺门60MIN,再灌注120MIN;七氟醚-肺缺血/再灌注组(C组),阻断左肺门60MIN,再灌注120MIN,从阻断时开始吸入1MAC七氟醚,直至再灌注完毕,共持续吸入七氟醚180MIN;丙泊酚-肺缺血/再灌注组,阻断左肺门60MIN,再灌注120MIN,从阻断时开始经耳缘静脉泵入20mg/kg/h丙泊酚,直至再灌注完毕,共持续泵入丙泊酚180MIN。实验结束后测定肺组织超氧化物歧化酶(SOD),丙二醛(MDA),肺湿干重比(W/D),支气管肺泡灌洗液(B A L F)中白细胞分类计数和肺通透性指数(LPI)。
     结果
     1.SOD和MDA的变化:①B组的SOD活力明显低于A组、C组和D组(P<0.05),C、D两组的SOD活力低于A组(P<0.05),C组和D组相比无显著性差异(P>0.05)。②B组的MDA含量明显高于A组、C组和D组(P<0.05),C、D两组的MDA含量低于A组(P<0.05),C组和D组相比无显著性差异(P>0.05)。
     2.BALF中白细胞分类及计数:B组白细胞数、PMN计数显著高于A组、C组和D组,C、D两组的白细胞数、PMN计数高于A组(P<0.05),C组和D组相比无显著性差异(P>0.05)。
     3.肺湿干重比(W/D)及肺通透性指数的变化:①B组的湿干重比明显高于其他三组(P<0.05),C、D两组的肺湿干重比高于A组(P<0.05),C组和D组相比无显著性差异(P>0.05)。②B组的肺通透性指数明显高于其他三组(P<0.05),C、D两组的肺通透性指数高于A组(P<0.05),C组和D组相比无显著性差异(P>0.05)。
     结论:
     1.家兔肺缺血/再灌注时,肺组织发生明显损伤。
     2.七氟醚和丙泊酚对家兔肺缺血/再灌注损伤均具有保护作用,两者对比无显著性差异。
Objective:To investigate the effect of sevoflurane and propofol on lung ischemia-reperfusion injury in rabbit in vivo.
     Methods:Forty healthy rabbits of either sex weighing 1.5-2.5kg were randomly divided into four groups of ten each:Compared(group A):Chest was opened and left main bronchus and pulmonary artery and vein were isolated but not clamped.The lungs were ventilated for 180 min;Ischemia-reperfusion(group B):left hilum was isolated and clamped for 60min,after declamping the lungs were ventilated for 120 min;Sevoflurane+ ischemia-reperfusion(group C):the lungs were ventilated with 1 MAC sevoflurane for 180 min,during this period,left hilum was isolated and clamped for 60min,then declamping for 120min.Propfol+ ischemia-reperfusion(group D):Propofol was lasting infused into intravenous,during this period,left hilum was isolated and clamped for 60min,then declamping for 120min.
     Results:
     1.Changes of SOD active unit and MDA content:①The SOD active unit of left lung was signifigantly lower in group B than those in group A,group C and group D(P<0.05).Compared with group C and group D, the SOD active unit of left lung was signifigantly higher in group A(P<0.05).There was no significant distinct between group C and group D(P>0.05).②The MDA content of left lung was signifigantly higher in group B than those in group A,group C and group D(P<0.05).Compared with group C and group D,the MDA content of left lung was signifigantly lower in group A(P<0.05).There was no significant distinct between group C and group D(P>0.05).
     2.Changes of W/D ratio and LPI:①The W/D ratio of left lung was signifigantly higher in group B than those in group A,group C and group D(P<0.05).Compared with group C and group D,the W/D ratio of left lung was signifigantly lower in group A(P<0.05).There was no significant distinct between group C and group D(P>0.05).②LPI of left lung was signifigantly higher in group B than those in group A,group C and group D(P<0.05).Compared with group C and group D,LPI of left lung was signifigantly lower in group A(P<0.05).There was no significant distinct between group C and group D(P>0.05).
     3.The category and counting of WBC in BALF:The counting of WBC and PMN cells of left lung was signifigantly higher in group B than those in group A,group C and group D(P<0.05).Compared with group C and group D,the counting of WBC and PMN cells of left lung was signifigantly lower in group A(P<0.05).There was no significant distinct between group C and group D(P>0.05).
     Conclusions:
     1.The lungs structure was severely destroyed when the lungs suffered LIRI.
     2.Sevoflurane and propofol could protect the lungs against LIRI in rabbit in vivo,and there was no significant distinct between them.
     3.Neither Sevoflurane could completely protect the lungs against LIRI in rabbit in vivo nor propofol.
引文
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