七氟烷对单肺通气肺损伤的保护作用及其机制

七氟烷对单肺通气肺损伤的保护作用及其机制
金晶星;李元海;陈珂;钟薇薇
【期刊名称】《安徽医科大学学报》
【年(卷),期】2012(47)4
【摘要】To evaluate the effect of sevoflurane on lung injury induced by one-lung ventilation and its mechanism. Methods 61 patients undergoing lung cancer surgery under one-lung ventiliation were evaluated in this study. The patients were randomly divided into two groups: control group ( group I , n = 29 ), sevoflurane group( II group,n = 32 ). Two groups were induced by the same way. Anesthesia was maintained with 1% ~3% sevoflurane or propofol TCI in two groups. Serum IL-8,TNF-a,oxygenation index levels,the expression of aquaporin l( AQP1 ) AQP4 and pathological features of the lung tissue were measured at intubation( Tl ), one-lung ventilation 90 min ( T2 ),two lung ventilation 30 min( T3 ). Results Compared with Tl ,the plasma of IL-8^TNF-a was increased obviously in both groups at T2, T3( P < 0. 05 ); Compared with Tl, the oxygenation index was declined dramatically at T2,T3( P < 0. 05 );The expression of AQP1 and APQ4 in lung tissue in two groups had no obvious difference; Compared with Tl ,the expression of AQP1 and APQ4 at T2 reduced dramatically in group I ( P <0. 05 ). Conclusion Sevoflurane can exert a protective effect on the lung injury result from one-lung ventilation, and its mechanism may be related to reducing the level of IL-8 and TNF-α in
blood plasma and up-regulating the expression of AQP1 and AQP4 in lung tissue.%目的探讨七氟烷对单肺通气肺损伤的保护作用及其可能机制.方法择期行肺癌根治术患者61例,ASA Ⅱ~Ⅲ级,随机分为两组:对照组(Ⅰ组,n=29),七氟烷组(Ⅱ组,n=32);两组采用相同的麻醉诱导方式,气管插管后,I组用全凭静脉维持麻醉,Ⅱ组用七氟烷全程吸入维持麻醉.所有患者分别于插管即刻(T1)、单肺通气90
min(T2)、术毕双肺通气30 min(T3),3个时间点分别测定血浆中白介素8(IL-8)、肿瘤坏死因子-α(TNF-α)含量、动脉血气及测定肺组织水通道蛋白1(AQP1)、水通道蛋白4(AQP4)表达,观察肺组织病理改变.结果与T1时比较,T2、T3时各组血浆中IL-8、TNF-α均明显增高(P<0.01),两组在T3时比较差异有显著性(P<0.05);与T1比较,T2氧合指数明显下降(P<0.05),两组在T3时比较差异有显著性
(P<0.05);两组在T1时肺组织AQP1和AQP4表达均差异无显著性;与T1时比较,T2时Ⅰ组AQP1和AQP4表达显著降低(P<0.05),Ⅱ组变化不明显.结论七氟烷对单肺通气所致的肺损伤有保护作用,其机制可能通过降低血浆中IL-8和TNF-α水平及上调肺组织中AQP1和AQP4的表达.
【总页数】4页(P446-449)
【作者】金晶星;李元海;陈珂;钟薇薇
【作者单位】安徽医科大学第一附属医院麻醉科,合肥,230022;安徽医科大学第一附属医院麻醉科,合肥,230022;安徽医科大学第一附属医院麻醉科,合肥,230022;安徽医科大学第一附属医院麻醉科,合肥,230022
【正文语种】中文
【中图分类】R614;R614.2
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