硫酸镁预处理对单肺通气所致缺血再灌注肺损伤的影响

Effects of magnesium sulphate pretreatment on ischemia reperfusion injury in patients undergoing one-lung ventilation

目的观察硫酸镁预处理对单肺通气缺血再灌注所致肺损伤的保护作用。方法择期在胸腔镜下行肺叶切除术患者80名,随机分为硫酸镁组(M组,n=40)和对照组(C组,n=40)。硫酸镁组给予硫酸镁静脉输注,对照组给予等量生理盐水。分别于麻醉诱导前1分钟(T_0)、单肺通气前1分钟(T_1)、单肺通气结束前1分钟(T_2)、双肺通气30分钟(T_3)时测定血清丙二醛(MDA)的浓度;从患侧肺叶取小块正常肺组织,测定该肺组织血红素氧合酶(HO-1)的含量;术后2h抽取桡动脉血1ml作血气分析,计算氧合指数。结果 T_3时刻血清MDA浓度M组低于C组(P<0.05),术侧肺叶组织HO-1浓度M组高于C组(P<0.05),术后2小时时肺氧合指数M组高于C组(P<0.05)。结论硫酸镁预处理对单肺通气患者的缺血再灌注损伤具有保护作用,其机制可能与上调肺组织HO-1的表达水平,抑制细胞脂质过氧化反应有关。

Objective To investigate the Effects of magnesium sulphate pretreatment on one lung ventilation（OLV） induced ischemia reper-fusion injury. Methods Eighty patients undergoing pulmonary lobecto-mythoracic by VATS with OLV were randomly randomized in group M and group c,each 4 cases. The magnesium sulphatewas givenbefore anesthesia induction in group M, and normal salinewas given in group C. The level of malonaldehyde（MDA）was detected at1 min before the anesthesia induction（T_0）, 1 min before one-lung ventilation（T_1）, 1 min before the end of onelung ventilation（T_2）, 30 mins after one-lung ventilation（T_3） on one lung ventilation（OLV）. The expression of hemeoxygenase-1 in the normal lung tissue of affected side lung was detected. 1 m L radial artery blood samples were extracted for calculating the oxygenation index（ PaO_2/FiO_2）at 2 h after surgery. Results At the time point of T_3,the level of serum MDA was obviously lower in group M than that in group C（P〈0.05）.The expression of HO-1 of removal lung tissue was remarkable higher in group M than that in Group C（ P〈0.05）. At 2 h after surgery, the oxygenation index（PaO_2/FiO_2） was significantly higher in group M than in group C（P〈0.05）. Conclusion The findings suggest that magnesium sulphate pretreatment can inhibit the lung ischemia reperfusion injury caused by one-lung ventilation,which is probably related to inhibition of lipid peroxidation,and up-regulating the expression of HO-1.