布比卡因影响小鼠肺泡上皮液体清除的作用机制研究

Mechanism research on the effects of bupivacaine on alveolar fluid clearance in mice

目的探讨布比卡因对小鼠肺泡液体清除率(AFC)的影响及机制。方法将48只小鼠分为六组。麻醉后经气管插管注入0.3 mL等渗5%小牛血清白蛋白(BSA),对照组、阿米组、布比组、布比+阿米组、特布组及布比+特布组BSA液中分别含有空白液、1 mmol/L阿米洛利、1 mmol/L布比卡因、1 mmol/L布比卡因+1 mmol/L阿米洛利、0.1 mmol/L特布他林及1 mmol/L布比卡因+0.1 mmol/L特布他林。注射30 min后负压吸取肺泡内液体,测定小牛血清白蛋白浓度,计算AFC。结果与对照组比较,布比组、阿米组及布比+阿米组AFC明显降低,P均<0.05;特布组AFC明显增加,特布+布比组AFC明显高于特布组。结论临床上布比卡因所致急性肺水肿的发生可能与AFC降低,抑制肺泡上皮钠通道有关;特布他林能拮抗布比卡因对AFC的抑制作用。

Objective To explore the effects of bupivacaine on alveolar fluid clearance （AFC） in mice and its mecha- nism. Methods Total of 48 mice were divided into six groups, 0.3 mL of iso-osmotic 5 % bovine serum albumine （BSA） was instilled intratracheally after anaesthesia. BSA of the control group, amiloride group, bupivacaine group, bupivacaine ＋ amiloride group, terbutaline group, and bupivacaine ＋ terbutaline group, include one of the followings： blank, 1 mmol/L amiloride, 1 mmol/L bupivacaine, 1 mmol/L bupivacaine ＋ 1 mM amiloride, O. 1 mM terbutaline and 1 mM bupivacaine ＋ 0.1 mM terbutaline, respectively. AFC was measured using bovine serum albumin protein assays in the ex- traction fluid after 30 min. Results Compared with the control group, AFC in the bupivacaine group , amiloride group and bupivacaine ＋ amiloride group decreaseed significantly （ all P 〈0. 05 ）, no significant difference were found between the former two groups; Compared with the control group, AFC in the terbutaline group and bupivacaine ＋ terbutaline group in- creased significantly,especially in the former group. Conclusions The reduction of AFC following application of bupiva- caine may be the crucial step of the pathogenesis of pulmonary edema and terbutaline can reverse the inhibitory effects of bupivacaine.