摘要
目的 探讨不同剂量氯诺昔康预先给药对常温闭胸式体外循环（CPB）兔肺损伤的影响及其可能机制。方法 成年新西兰白兔24只,雌雄不拘,体重2．5～3．5kg,随机分成3组（n=8）：C组仅行CPB不应用氯诺昔康,L1组和L2组分别于CPB前30min静脉注射氯诺昔康0．7、1．4mg/kg。右颈总动脉和右颈总静脉插管建立常温闭胸式体外循环模型,于CPB转流前即刻（T1）、转流5min（T2）、转流60min（T3）、转流结束后60 min（T4）时取右颈总静脉血,测定血浆肿瘤坏死因子-α（TNF-α）、内皮素-1（ET-1）及血栓素B2（TXB2）的浓度;T4时处死动物,采集右肺支气管肺泡灌洗液（BALF）,测定总蛋白含量,左肺上缘取肺组织,测定髓过氧化物酶（MPO）活性,并行光镜、电镜检查。结果 与C组比较,L1组和L2组T2～T4时血浆TNF-α、ET-1、TXB2浓度均降低（P＜0．05或0．01）,BALF总蛋白含量和肺组织MPO活性均降低（P＜0．01）;与T1比较,各组T2～T4时血浆TNF-α、ET-1、TXB2浓度均升高（P＜0．01）。病理学检查示L1组和L2组肺组织损伤较C组轻。结论 氯诺昔康预先给药可通过降低炎性反应减轻兔常温闭胸式体外循环所致肺损伤。
Objective To investigate the effect of different doses of lornoxicam on lung injury induced by normothermic cardiopulmonary bypass （CPB） and the possible mechanism. Methods Twenty-four adult New Zealand white rabbits of both sexes weighing 2.5-3.5 kg were randomly divided into 3 groups （ n = 8 each） ： group Ⅰ control and group Ⅱ-Ⅲ received lornoxicam 0.7 and 1.4 mg/kg intravenously respectively 30 min before CPB. The animals were anesthetized with urethane, tracheostomized and mechanically ventilated with pure oxygen. Right common carotid and right jugular vein were cannulated for closed-chest CPB. Blood samples were taken immediately before CPB （baseline, T1 ） at 5 and 60 min of CPB and 60 min after discontinuation of CPB for determination of plasma TNF-α, TXB2 and ET-1 concentrations. The animals were then killed and the lungs were removed for （1） lung lavage, （2） microscopic examination of the lung tissue and （3） determination of myoloperoxidase （MPO） activity in the lung tissue. Results CPB significantly increased plasma TNF-α, TXB2 and ET-1 concentrations as compared with the baseline values at T1 . Pretreatment with lornoxicam 0.7 and 1.4 mg/kg （group Ⅱ and Ⅲ ） significantly attenuated the CPB-induced increase in plasma TNF-α, TXB2 and ET-1 concentrations. The MPO activity in the lung tissue and protein concentration in broncho-alveolar lavage fluid were significantly lower and tissue damage was significantly attenuated in group Ⅱand Ⅲ as compared with control group. Conclusion Lornoxicam pretreatment can attenuate the lung injury induced by normothermic CPB in rabbits through decreasing inflammatory response.
出处
《中华麻醉学杂志》
CAS
CSCD
北大核心
2007年第4期305-308,共4页
Chinese Journal of Anesthesiology
关键词
环加氧酶抑制药
呼吸窘迫综合征
成人
心肺转流术
Cyclooxygenase inhibitors
Respiratory distress syndrome, adult
Cardiopulmonary bypass
