依托咪酯预处理对肺缺血再灌注损伤的影响

Effects of etomidate preconditioning on lung ischemia reperfusion injury

目的探讨依托咪酯预处理对肺缺血再灌注损伤的影响。方法选择清洁级SD大鼠48只,完全随机分为对照组、丙泊酚组和依托咪酯组,每组16只,3组均建立肺缺血再灌注损伤模型,模型建立后对照组不给予任何处理,丙泊酚组给予丙泊酚预处理,而依托咪酯组给予依托咪酯预处理,观察3组肺损伤程度并进行比较。结果对照组可见大量肺泡萎陷,肺泡腔内有大量红细胞渗出;丙泊酚组和依托咪酯组均可见部分肺泡萎陷,肺泡腔内有红细胞渗出。依托咪酯组的全肺质量和脏器系数明显低于丙泊酚组与对照组(P均<0.05),丙泊酚组与对照组比较差异均无统计学意义(P均>0.05)。依托咪酯组的TUNEL阳性细胞凋亡指数明显低于丙泊酚组与对照组(P均<0.05),而丙泊酚组与对照组比较差异无统计学意义(P>0.05)。依托咪酯组肺组织肿瘤坏死因子α与白细胞介素含量均明显低于丙泊酚组与对照组(P均<0.05),而丙泊酚组与对照组比较差异均无统计学意义(P均>0.05)。结论肺缺血再灌注会诱发肺损伤,依托咪酯预处理可以明显减轻肺部炎性反应和肺组织凋亡,对肺损伤有一定的保护作用,其作用可能与下调肺损伤时TNF-α与IL-6的表达有关。

Objective It is to investigate the influence of etomidate pretreatment on lung ischemia reperfusion injury.Methods 48 cases of SD rats were selected and completely equally randomly divided into control group,propofol group and etomidate groups,16 cases in each group,all rats in the three groups were established the model of lung ischemia reperfusion injury,then the animals were given propofol pretreatment in the propofol group and etomidate pretreatment in the etomidate group,but did not carry out any treatment in the control group. The degree of lung injury and the expression of tumor necrosis factor alpha and interleukin- 6 in the lung tissue in the 3 groups were observed and compared. Results Pathology results showed that a large number of alveolar were atrophied and collapsed,and the alveolar cavity had a large number of red blood cell infiltration in the control group; and partial alveolar were atrophied and collapsed,and the alveolar cavity had any red blood cells in the propofol group and etomidate group. The total lung mass and lung coefficient of etomidate group were significantly lower than those of propofol group and control group（ all P 0. 05）,but there was no significance difference between propofol group and control group（ P 0. 05）. The apoptotic index of TUNEL positive in the etomidate group was significantly lower than those in the propofol group and the control group（ all P 0. 05）,but there was no significance difference between the propofol group and the control group（ P 0. 05）. The levels of tumor necrosis factor alpha and interleukin- 6 in lung tissue of etomidate group were significantly lower than those in the propofol group and the control group（ all P 0. 05）,but there was no significant difference between the propofol group and the control group（ P 0. 05）. Conclusion The lung ischemia reperfusion can induce lung injury,etomidate pretreatment can significantly reduce lung inflammation and lung apoptosis,it has protective effect for lung injury,its effect may be reduced the expression of lung tumor necrosis factor alpha and interleukin-6 in lung tissue.