上海交通大学学报（医学版）

›› 2012, Vol. 32 ›› Issue (3): 330-.doi: 10.3969/j.issn.1674-8115.2012.03.020

• 论著（临床研究） • 上一篇    下一篇

异氟烷后处理对脓毒症诱发急性肺损伤大鼠的保护作用

董 翔, 胡 蓉, 吕 翔, 李启芳, 姜 虹, 朱也森   

  1. 上海交通大学 医学院附属第九人民医院麻醉科, 上海 200011
  • 出版日期:2012-03-28 发布日期:2012-03-28
  • 通讯作者: 姜 虹, 电子信箱: dr.jianghong@yahoo.com.cn。
  • 作者简介:董 翔（1980—）, 男, 主治医师, 硕士生；电子信箱: dongxiangsh@hotmail.com。

Protective effect of isoflurane posttreatment on acute lung injury induced by sepsis in rats

DONG Xiang, HU Rong, LV Xiang, LI Qi-fang, JIANG Hong, ZHU Ye-sen   

  1. Department of Anesthesiology, the Ninth People's Hospital, Shanghai Jiaotong University School of Medicine, Shanghai 200011, China
  • Online:2012-03-28 Published:2012-03-28

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摘要：

目的 研究异氟烷（ISO）后处理对脓毒症诱发急性肺损伤（ALI）大鼠肺泡毛细血管通透性及一氧化氮（NO）和诱导型一氧化氮合酶（iNOS）活性的影响。方法 120只雄性SD大鼠随机分为假手术组（Sham组）、假手术后ISO干预组（ShamISO组）、脓毒症诱发ALI模型组（ALI组）和脓毒症诱发ALI后ISO干预组（ALI-ISO组），每组30只。取ALI组和ALI-ISO组大鼠，采用盲肠结扎穿孔法（CLP）建立脓毒症诱发ALI模型，建模后6 h，ALI-ISO组大鼠予以吸入1.0 MAC ISO 2 h。每组留取10只大鼠进行生存率分析。每组随机取10只大鼠，于处死前30 min经静脉注射伊文思蓝，取肺组织进行肺泡通透性检查（伊文思蓝含量测定）。各组其余10只大鼠处死前采血测定血清NO含量；取右肺行组织病理学检查及蛋白检测；测定肺湿/干质量比和肺水含量，进行支气管肺泡灌洗液(BALF)中性粒细胞计数并计算肺泡通透性指数 (LPI)，检测肺组织iNOS活性。结果 ALI-ISO组大鼠建模后24、48 h和10 d的生存率均高于ALI组。对各组大鼠的肺组织病理形态学积分、肺湿/干质量比、肺水含量、肺组织伊文思蓝含量、LPI、血清NO含量、肺组织iNOS活性等指标的统计学分析结果显示：ALI组和ALI-ISO组各项指标均明显高于Sham组和Sham-ISO组(P<0.05)，而ALI-ISO组各项指标均显著低于ALI组(P<0.05)。BALF中性粒细胞计数结果显示：ALI组和ALI-ISO组均显著高于Sham组和Sham-ISO组(P<0.05)，ALI组与ALI-ISO组比较差异无统计学意义（P>0.05）。结论 1.0 MAC ISO后处理可降低脓毒症诱发ALI大鼠的肺泡毛细血管通透性，减轻ALI程度，提高生存率。

关键词: 异氟烷, 后处理, 急性肺损伤, 肺泡毛细血管通透性, 一氧化氮, 诱导型一氧化氮合酶

Abstract:

Objective To investigate the effect of isoflurane (ISO) posttreatment on the membrane permeability of alveolar capillaries and activity of nitric oxide (NO) and inducible nitric oxide synthase (iNOS) in acute lung injury (ALI) induced by sepsis in rats. Methods One hundred and twenty male SD rats were randomly divided into sham operation group (Sham group), ISO intervention after sham operation group (Sham-ISO group), ALI model induced by sepsis group (ALI group) and ISO intervention after ALI induced by sepsis group (ALI-ISO group), with 30 rats in each group. Rats in ALI group and ALI-ISO group were selected, and ALI model induced by sepsis was established by cecal ligation and puncture (CLP). Six hours after model establishment, rats in ALI-ISO group inhaled 1.0 MAC ISO for 2 h. Ten rats in each group were served for survival analysis. Ten rats in each group were randomly selected, Evans blue was intravenously injected 30min before sacrifice, lung tissues were obtained for examination of permeability of alveoli (Evans blue content determination). Blood samples were taken from the rest of 10 rats in each group before sacrifice, serum NO contents were measured, right lung tissues were obtained for histopathological examination and protein detection, wet/dry weight ratios and water content were measured, neutrophil counts in bronchoalveolar lavage fluid (BALF) were obtained, lung permeability indexes (LPI) were calculated, and the activity of iNOS in lung tissues was determined. Results The survival of rats in ALI-ISO group 24 h,48 h and 10 d after model establishment was higher than that in ALI group. The parameters of histopathologic accumulative score, lung wet/dry weight ratio, water content of lung, Evans blue content in lung tissues, LPI, serum NO content and activity of iNOS in lung tissues in ALI group and ALI-ISO group were significantly higher than those in Sham group and Sham-ISO group (P<0.05), while these parameters in ALI-ISO group were significantly lower than those in ALI group (P<0.05). The neutrophil counts in BALF in ALI group and ALI-ISO group were significantly higher than those in Sham group and Sham-ISO group (P<0.05), while there was no significant difference between ALI group and ALI-ISO group (P>0.05). Conclusion Posttreatment with 1.0 MAC ISO can reduce the membrane permeability of alveolar capillaries in ALI induced by sepsis, attenuate severity of ALI, and increase the survival.

Key words: isoflurane, posttreatment, acute lung injury, membrane permeability of alveolar capillary, nitric oxide, inducible nitric oxide synthase