己酮可可碱对兔单肺通气急性肺损伤的保护作用

Protective effect of pentoxifylline on acute pulmonary injury after one-lung ventilation in rabbits

目的观察己酮可可碱对实验兔单肺通气肺损伤的影响。方法20只新西兰白兔麻醉后气管切开行单侧主支气管插管机械通气后,随机分为对照组(单肺通气组,n=10)和实验组(单肺通气+己酮可可碱静脉滴注组,n=10),采用容量控制机械通气模式(Vt=8ml/kg,f=30次/min)通气3h。分别于麻醉后及单肺通气3h后抽取血样行动脉血气分析测定氧合指数。实验完成后处死白兔,取其肺叶组织测量肺湿/干重比(W/D),检测支气管肺泡灌洗液(BALF)中肿瘤坏死因子-α(TNF-α)、一氧化氮(NO)、丙二醛(MAD)水平及超氧化物歧化酶(SOD)活力,观察肺组织病理形态学变化。结果与对照组比较,实验组氧合指数提高(P<0.05);W/D降低(P<0.05);BALF中TNF-α、NO含量及MAD水平下降(P<0.05)、SOD活力水平明显升高(P<0.01);病理损伤程度较轻。结论己酮可可碱可改善单肺通气功能,减轻肺损伤程度,对兔单肺通气所致肺损伤起到一定的保护作用。

Objective To investigate the effect of pentoxifylline on one-lung ventilation injury in rabbits. Methods Twenty rabbit models of one-lung ventilation by intrabronchial intubation after tracheotomy were randomly allocated in control group （with one-lung ventilation） and experiment group （with one-lung ventilation and intravenous pentoxifylline administration）. One-lung ventilation was maintained for 3 h in both groups using the volume-control mode （tidal volume of 8 ml/kg at the frequency of 30 per min）. Arterial blood samples were taken after anesthesia and at 3 h of one-lung ventilation for arterial blood gas analysis to obtain the oxygenation index. At the end of the experiment, the pulmonary wet/dry ratio （W/D）, tumor necrosis factor-α （TNF-α）, NO, malondialdehyde （MDA） and superoxide dismutase （SOD） contents in bronchoalveolar lavage fluid （BALF） were measured and the histological appearance of the lung tissue was observed. Results The oxygenation index was significantly higher （P〈0.05）, W/D ratio lower （P〈0.05）, and contents of TNF-α, NO and MAD in the BALF lower in the experimental group than in the control group （P〈0.05）. The activity of SOD increased significantly in the experimental group as compared with the control group （P〈0.01）, and the rabbits in the experimental group showed milder pathological changes. Conclusion Intravenous pentoxifylline may improve pulmonary ventilation function and alleviate pulmonary injury, thus offering protection against pulmonary injury after one-lung ventilation.