利多卡因对肢体缺血-再灌注时炎性介质表达的影响

Effecfs of lidocaine on expressions of inflammatory mediators in patients with ischemia-reperfusion injury of the limbs

目的研究利多卡因对肢体缺血-再灌注炎性介质血栓素B2(TXB2)、前列腺素(6-Keto-PGFIα)、白细胞介素8(IL-8)、过氧化脂质(LPO)和一氧化氮(NO)的影响。方法28例择期肢体手术伴有缺血-再灌注的患者随机分为利多卡因治疗(L)组和对照(C)组,测定TXB2、6-Keto-PGFIα、IL-8、LPO和NO的水平。结果肢体缺血-再灌注后10min,C组LPO显著升高,再灌注后18min,TXB2、TXB2/6-KetoPGFIα、IL-8和LPO均显著增高,NO显著降低。L组各炎性介质则无明显变化。结论肢体缺血-再灌注损伤是由炎症反应引起的自身免疫损伤,利多卡因对此有明显的防治作用。

Objective To study the effects of lidocaine on the expressions of TXB2, IL-8, LPO and NO in the patients with ischemia-reperfusion injury of the limbs during operation. Methods Twenty-eight cases undergoing selective limb operation with ischemia-reperfusion were divided randomly into lidocaine treated group（L）and control group（C）. The expressions of TXB2, IL-8, IL- 8, LPO and NO were detected. Results In group C, LPO was increased markedly at 10 min after reperfusion, and TXB2, IL-8,TXB2/6-Keto-PGFIα and LPO were all increased significantly at 18 min after limb reperfusion , which were not significantly changed in group L. Conclusion The ischemiareperfusion injury of the limbs is an autoimmune injury produced by inflammatory responses. Lidocaine has an obvious protective effect on the limbs underwent ischemia-reperfusion.