星状神经节阻滞对盐酸致家兔急性肺损伤的保护作用

Effects of stellate ganglion block on hydrochloric acid induced acute lung injury in rabbits

目的探讨星状神经节阻滞(stellate ganglion block,SGB)对盐酸致家兔急性肺损伤(acutelung injury,ALI)肺功能的影响。方法 30只健康成年家兔随机均分成3组(n=10):盐水对照组(A组)、盐酸模型组(B组)和SGB干预组(C组)。A组气管内给1.5 mL/kg生理盐水;B组麻醉后气管内给予pH1.5盐酸1.5 mL/kg建立吸入性肺损伤模型;C组模型建立后给予0.25%布比卡因0.5 mL/h行右侧星状神经节阻滞。模型建立后6 h处死动物,测定血清及支气管肺泡灌洗液(BALF)中TNF-α、IL-6及IL-10浓度,测定湿干重比值(W/D),取肺组织观察光镜和电镜下肺组织损伤程度。结果与对照组相比,盐酸组及SGB组的血清及BALF中TNF-α、IL-6及IL-10的浓度显著升高(P<0.05),肺组织湿干重比值明显升高(P<0.05),肺组织损伤程度较重;与盐酸组相比,SGB组血清及BALF中TNF-α、IL-6浓度显著降低(P<0.05),IL-10浓度显著升高(P<0.05);肺组织湿干重比值显著降低(P<0.05),肺组织损伤程度较轻。结论星状神经节阻滞可降低促炎因子TNF-α、IL-6的释放,可增加抗炎因子IL-10的表达,有利于肺损伤的改善。

Objective To study the influence of stellate ganglion block on rabbit acute lung in- jury induced by hydrochloric acid. Methods Thirty male New Zealand rabbits were randomly divided into the normal control group （group A）, the injury control group （group B ） and the SGB group（ group C）. In the normal control group, rabbits received normal saline through tra- chea in equal volume as that given in the injury control group; in the injury control group, rab- bits received pH 1.5 hydrochloric acid infusion of 1.5 mL/kg; and in the SGB group, 0. 25% bupivacaine 0. 5 mL/h was injected through catheter into right stellate ganglion. Six hours after hydrochloric acid injection, the animals were killed. Then the pathological manifestation was observed, the lung wet/dry ratio was calculated, while the concentration of TNF-a, IL-6 and IL-10 in serum and BALF were detected. Results Compared with A group, the concentration of TNF-a, IL-6 and IL-10 in serum and BALF increased significantly in B and C group （P 〈 0. 05 ）, the wet/dry ratio increased significantly in B and C group （P 〈 0. 05 ）. Compared withB group, the concentration of TNF-a, IL-6 and IL-10 in serum and BALF decreased signifi- cantly in C group （P 〈 0.05 ）, the wet/dry ratio decreased significantly in C group （P 〈 0. 05）. Conclusion SGB is effective to the hydrochloric acid induced ALl in rabbits. SGB may lessen the inflammatory reaction through depressing the TNF-a, IL-6 concentration and in- creasing the IL-10 concentration.