依达拉奉预处理对单肺通气患者HGMB1的影响

Effects of edaravone preconditioning on HGMB1 in patients with one lung ventilation

目的评估依达拉奉预处理对单肺通气（OLV）患者高迁移率族蛋白B1（HMGB1）的影响。方法选择需OLV患者50例，年龄62-75岁，ASA分级Ⅰ-Ⅱ级，按随机数字表法分为2组（n=25）：对照组（生理盐水）、观察组（依达拉奉），每组25例。观察组麻醉前微量泵静脉注射依达拉奉5mg／kg，30min内注射完成，对照组注射等容积生理盐水。2组分别在依达拉奉注射前（T1）、OLV3h（T2）、术后24h（T3）、术后48h（Td）检测HMGB1，并记录血氧饱和度（SaO2），在麻醉后OLV前、T2时点记录患者呼气末二氧化碳分压（PETCO2）、气道平台压（Ppean）、气道峰压（Ppeak）；记录术后48h内发生急性肺损伤（Au）、急性呼吸窘迫综合征（ARDS）例数。结果观察组T2-T4时点HMGB1、SaO2均高于对照组；观察组T2时点PETCO2、Ppean、Ppeak低于对照组；观察组术后48h内发生ALI／ARDS例数低于对照组（P均〈0．05）。结论依达拉奉可以通过降低HMGB1表达减轻肺损伤，保护肺功能。

Objective To evaluate the effects of edaravone preconditioning on high - mobility group box 1 （ HMGB1 ） in patients with one - lung ventilation （OLV）. Methods Fifty ASA physical status I - II patients of both sexes, aged 62 -75 years,who underwent elective OLV, were randomized to control group （saline group） and observation group （ edaravone preconditioning group） according to random number table, with 25 cases in each group . The observa- tion group received intravenous injection of edaravone 5 mg/kg before anesthesia and the injection was finished within 30 min, while control group received equal volume of normal saline. Serum levels of HMGB1 were determined before edara- vone injection（Tl ） ,at 3 h（T2） and 24 h （T3 ） of OLV, and at 48 h after operation（T4）, and SaO2 was recorded at the same time. Mean airway pressure （Pmean）, peak airway pressure （Ppeak） and end -tidal carbon dioxide pressure （PET CO2 ）were recorded before OLV and at 3 h of OLV （T2 ）. The incidence of acute lung injury （ALI）/acute respiratory distress syndrome （ARDS） at 48 h after operation was recorded. Results The levels of HMGB1 and SaO2 of the observa- tion group were higher than those of the control group at T2 -T4 （P 〈0.05）. PETCO2, Ppean and Ppeak in observation group were lower than those in control group at 3 h of OLV （P 〈 O. 05）. The HMGB1 and SaO2 of group B were higher than those in group A at T2-4 （P 〈 0.05） ; The Ppean, Ppeak, The incidence of ALI/ARDS of group B were lower than group A at 48 h after operation （P 〈 0.05 ）. Conclusions Edaravone may reduce lung injury and protect lung function by reducing the expression of HMGB1.