异丙酚对急性肺损伤兔氧合指数和中性粒细胞弹性蛋白酶的影响

Effect of propofol on oxygenation index and serum neutrophil elastase in rabbits with acute lung injury induced by oleic acid

目的观察异丙酚对油酸性急性肺损伤兔氧合指数和血清中性粒细胞弹性蛋白酶的影响，探讨异丙酚治疗油酸性急性肺损伤的可能机制。方法健康日本大耳白兔24只，按照随机数字表法将其分成对照组（1组）、油酸性急性肺损伤组（Ⅱ组）和异丙酚治疗组（Ⅲ组）。Ⅱ、Ⅲ组静脉注射油酸0．08ml·kg^-1，制备急性肺损伤兔模型。造模成功后Ⅲ组静脉注射异丙酚8mg·kg^-1·h^-1，Ⅰ、Ⅱ组静脉注射等量0．9％氯化钠溶液0．8l·kg^-1。各组大耳白兔分别在输入异丙酚或0．9％氯化钠溶液前（T0）和给药后1h（T_1）、2h（T_2）、3h（T_3）、4h（T_4）采集动脉血，行血气分析检测PaO_2并计算氧合指数，采用ELISA法检测血清NE的水平。结果Ⅰ组各时间点氧合指数无明显变化。Ⅱ组注射油酸造模成功后随着时间延长氧合指数逐渐下降。Ⅱ组氧合指数较Ⅰ组降低，但T，时刻以后较Ⅱ组高（P〈0．05）。Ⅱ组血清NE水平在T_1开始升高，^_2达高峰，T_3、T_4仍高于T_0水平（P〈005），与Ⅰ组各时点比较升高明显（P〈0．05）。Ⅲ组各时点升高幅度明显低于Ⅱ组（P〈0．05）。结论异丙酚能够提高氧合指数，降低兔油酸性急性肺损伤血清中性粒细胞弹性蛋白酶的水平，对兔油酸性急性肺损伤有一定的治疗作用。

Objective To investigate the effects of propofol on oxygenation index and serum neutrophil elastase （NE） in rabbits with acute lung injury （ALl） induced by oleic acid （OA）, Methods Twenty four Japanese white rabbits were randomly divided into three groups （n=8 in each）：control group （group Ⅰ ）,acute lung injury group （group Ⅱ ） and propofol treatment group （group Ⅲ ）. Rabbits in groups Ⅱ and III were infused with oleic acid （0.08 ml.kg^-1 ） through marginal veins of ear; then the rabbits in group Ⅲ were injected with propofol （8 mg .kg^-1 -h^-1） by pump, while the rabbits in groups Ⅰ and group Ⅱ were injected with same volumes of normal saline after establishing the ALI models. Artery blood samples were collected before （T_0） and lh（T_1）, 2h （T_2）, 3h（T_3）and 4h（T_4）after infusion of propofol or normal saline. PaO_2 and calculate oxygen index were measured and the serum neutrophil elastase levels were detected by ELISA. Results The oxygenation index at different time points had no significant change in group Ⅰ , which was decreased gradually after establishing the ALl in group Ⅱ ; while the oxygenation index in Group Ⅲ was lower than that of group Ⅰ , but higher than that of group Ⅱ （P 〈0.05） after ALI was induced, Serum NE levels in group Ⅱ started to rise at T_1 reached to the peak at T_2 and remained higher at T_3 and T_4 （P 〈0.05）. NE levels in Groups Ⅱ and Ⅲ were higher than those in group Ⅰ at each time points （P 〈0.05） but those in group Ⅲ were lower than Group Ⅱ. Conclusion Propofol can increase oxygenation index and reduce serum neutrophil elastase levels, which are associated with its protective effect in rabbits with acute lung injury induced by oleic acid.