间断通气预处理对肺癌根治术中单肺通气时肺损伤以及HIF-1α/HO-1表达的影响

Effects of intermittent ventilation pretreatment on one-lung ventilation-induced lung injury in radical operation for lung cancer as well as HIF-1α/HO-1 expression

目的:研究间断通气预处理对肺癌根治术中单肺通气时肺损伤以及HIF-1α/HO-1表达的影响。方法:选择在我院接受择期肺癌根治术的60例患者并分为间断通气组和常规通气组,分析术中的气道功能以及肺泡氧合功能,采集血清并测定肺损伤相关分子的含量,采集非通气侧肺组织并测定肺损伤相关分子、内质网应激相关分子的含量以及HIF-1α/HO-1的表达量。结果:两组T0、T1、T2时间点的Ppeak、Pplat、Raw、PaO_2无显著性差异(P>0.05),间断通气组T3时间点的Ppeak、Pplat、Raw均显著低于常规通气组且PaO2显著高于常规通气组(P<0.05);间断通气组血清中KL-6、sRAGE、SP-A的含量以及肺组织MPO、XOD、GRP78、CHOP、XBP1、ATF4、ATF6、PERK、HIF-1α、HO-1的含量显著低于对照组(P<0.05)。结论:间断通气预处理能够减轻肺癌根治术中单肺通气时的肺损伤,改善气道功能以及肺泡氧合功能,抑制内质网应激反应以及HIF-1α/HO-1的表达。

Objective：To study the effects of intermittent ventilation pretreatment on one-lung ventilation-induced lung injury in radical operation for lung cancer as well as HIF-1α/HO-1expression.Methods：A total of 60 patients undergoing selective radical operation for lung cancer in our hospital were selected and divided into intermittent ventilation group and conventional ventilation group,intraoperative airway function and alveolar oxygenation function were analyzed,serum was collected to determine the levels of lung injury-related molecules,and non-ventilation-side lung tissue was collected to determine the levels of lung injury-related molecules and endoplasmic reticulum stress-related molecules as well as the expression levels of HIF-1α/HO-1.Results：Ppeak,Pplat,Raw and PaO2 at T0,T1 and T2were not significantly different between two groups,Ppeak,Pplat and Raw of intermittent ventilation group at T3 were significantly lower than those of conventional ventilation group and PaO2 was significantly higher than that of conventional ventilation group;KL-6,sRAGE and SP-A levels in serum as well as MPO,XOD,GRP78,CHOP,XBP1,ATF4,ATF6,PERK,HIF-1αand HO-1levels in lung tissue of intermittent ventilationgroup were significantly lower than those of control group.Conclusion：Intermittent ventilation pretreatment can reduce onelung ventilation-induced lung injury in radical operation for lung cancer,improve airway function and alveolar oxygenation function,and inhibit endoplasmic reticulum stress and the expression of HIF-1α/HO-1.