异氟醚对家兔肺缺血-再灌注损伤的影响

Effect of isoflurane on lung ischemia-reperfusion injury in rabbit

目的 研究异氟醚对在体家兔肺缺血 再灌注 (I R)损伤的影响。方法 32只新西兰家兔根据Eppinger模型加以改进 ,建立在体兔肺缺血再灌注模型 ,随机分四组 (n =8) ,A组 :假手术组 ,开胸后维持通气 12 0min。B组 :缺血再灌注组 ,阻断左肺门 6 0min ,开放再通气 6 0min。C组 :异氟醚 +缺血再灌注组 ,缺血前吸入 1MAC异氟醚 30min ,开放再通气时也吸入 1MAC异氟醚。D组 :异氟醚组 ,持续吸入 1MAC异氟醚 12 0min ,观察各组实验结束时肺湿 干重比 (W D) ,肺丙二醛含量(MDA)和肺组织学改变以及术中血流动力学的改变。结果 B组及C组W D ,肺MDA含量均较A、D两组显著增高 ,(P <0 0 5 ) ,且病理切片显示 ,部分肺泡结构破坏 ,肺泡间隔增宽 ,肺泡腔水肿并有白细胞渗出 ,但B组改变明显严重 ,且B组W D ,肺MDA含量也明显高于C组 (P <0 0 5 ) ,血液动力学基本维持正常。结论 异氟醚对在体家兔肺I R损伤有一定的保护作用。

Objective To investigate the effect of isoflurane on lung ischemia reperfusion injury in rabbit in vivo Methods Thirty two healthy New Zealand white rabbits of either sex weighing 2 0 2 5kg were randomly divided into four groups of eight each:sham operation (group A): chest was opened and left main bronchus and pulmonary artery and vein were isolated but not clamped The lungs were ventilated for 120min; ischemia reperfusion (group B): left hilum was isolated and clamped for 60min, after declamping the lungs were ventilated for another 60min Isoflurane+ischemia reperfusion(group C): the lungs were first ventilated with 1MAC isoflurane for 15min then the left hilum was clamped for 60min, after declamping the lungs were ventilated with 1MAC isoflurane for another 60min Isoflurane(group D): left hilum isolated but not clamped The lungs were ventilated with 1MAC isoflurane for another 60min Animals were then killed by blood letting, left lung was excised for microscopic examination and measurement of wet/dry weight(W/D) ratio and MDA content Results The W/D ratio and MDA content of left lung were significantly higher in group B and group C than those in group A and group D, while W/D ratio and MAD content in group B were significantly higher than those in group C Microscopic examination showed that there were severe leukocyte infiltration and edema formation in alveolar spaces and alveolar structure was destroyed in group B and group C, but the changes were less severe in group C Conclusions Inhalation of 1MAC isoflurane before ischemia and during reperfusion protects the lungs against ischemia reperfusion injury in rabbit in vivo