银杏叶提取物注射液预防肢体缺血再灌注患者肺损伤的效果

Effect of Ginkgo Biloba Extract Injection on Lung Injury Caused by Extremity Ischemia-reperfusion

目的探讨银杏叶提取物注射液预防肢体缺血-再灌注损伤(IR)患者肺损伤的效果。方法选取2019年1月-2020年8月我院收治的96例择期行单侧下肢手术患者,随机分为对照组和观察组,每组48例。两组均行椎管-硬膜外联合麻醉,观察组于止血带充气前15 min静滴银杏叶提取物注射液,对照组给予等量生理盐水。比较两组止血带充气前(T1)、松开止血带10(T2)、30(T3)、60 min(T4)氧合指数(OI)、肺泡-动脉血氧分压差(PA-aO2)、呼吸指数(RI)、血清超氧化物歧化酶(SOD)、丙二醛(MDA)、白细胞介素-6(IL-6)、白细胞介素-8(IL-8)及肿瘤坏死因子-α(TNF-α)浓度。结果与T1时比较,两组T2~T4时OI、RI降低(P<0.05),PA-aO2增高(P<0.05),血清SOD水平降低(P<0.05),血清MDA、IL-6、IL-8、TNF-α水平升高(P<0.05);与对照组比较,观察组T2~T4时OI增高(P<0.05),PA-aO2、RI降低(P<0.05),血清SOD水平增高(P<0.05),血清MDA、IL-6、IL-8、TNF-α水平降低(P<0.05)。结论银杏叶提取物注射液对肢体IR所致肺损伤具有较好的保护效应,其机制可能与改善机体氧化应激和炎症级联反应有关。

Objective To evaluate the effect of Ginkgo biloba extract injection on lung injury caused by extremity ischemia-reperfusion(IR).Methods A total of 96 patients undergoing unilateral lower limb surgery in our hospital from January 2019 to August 2020 were selected and randomly divided into control group and observation group,with 48 cases in each group.The two groups were subjected to spinal-epidural anesthesia.Ginkgo biloba extract injection was intravenous dripped 15 min before tourniquet inflation in the observation group,and the control group was given the same amount of normal saline.Before tourniquet inflation(T1),10(T2),30(T3),60 min(T4)oxygenation index(OI),alveolar-arterial oxygen partial pressure difference(PA-aO2),respiratory index(RI),serum superoxide dismutase(SOD),malondialdehyde(MDA),interleukin-6(IL-6),interleukin-8(IL-8)and tumor necrosis factor-α(TNF-α)concentrations were compared between the two groups.Results Compared with T1,OI and RI decreased(P<0.05),PA-aO2 increased(P<0.05),serum SOD level decreased(P<0.05),serum MDA,IL-6,IL-8 and TNF-αlevels increased(P<0.05).Compared with the control group,the OI of the observation group increased(P<0.05),PA-aO2 and RI decreased(P<0.05),the serum SOD level increased(P<0.05),and the serum MDA,IL-6,IL-8 and TNF-αlevels decreased at T2-T4(P<0.05).Conclusion Ginkgo biloba extract injection can effectively reduce the lung injury caused by limb IR,the mechanism may be related to the improvement of oxidative stress and inflammatory cascade.