在缺血前使用异氟烷-七氟烷可减轻兔肺的缺血再灌注损伤

浮浮沉沉 · 发表于 2014-5-17 21:43:21

Isoflurane–Sevoflurane Administration before Ischemia Attenuates Ischemia–Reperfusion-induced Injury in Isolated Rat Lungs
Background: The effects of volatile anesthetics on ischemia– reperfusion (IR)–induced lung injury are not clear. The authors investigated the effects of preadministration of isoflurane and sevoflurane on IR-induced lung injury in an isolated buffer perfused at lung model.
Methods: Isolated rat lungs were designated into four groups: control group (n 5 6): perfusion for 120 min without ischemia; IR group (n 5 6): interruption of perfusion and ventilation for 60 min followed by reperfusion for 60 min; sevoflurane (SEVO)- IR (n 5 6) and isoflurane (ISO)-IR (n 5 6) groups: 1 minimum alveolar concentration (MAC) isoflurane or sevoflurane was administered for 30 min, followed by 60 min ischemia, then 60 min reperfusion. The authors measured the coefficient of filtration
(Kfc) of the lung, lactate dehydrogenase (LDH) activity, tumor necrosis factor a, and nitric oxide metabolites (nitrite 1nitrate) in the perfusate and the wet-to-dry lung weight ratio. Results: IR caused significant increases in the coefficient of filtration (approximately sevenfold at 60 min of reperfusion compared with baseline; P < 0.01), the wet-to-dry lung weightratio, the rate of increase of lactate dehydrogenase activity, and tumor necrosis factor a in the perfusate, and caused a significant decrease in nitric oxide metabolites in the perfusate. Administration of 1 MAC isoflurane or sevoflurane before ischemia significantly attenuated IR-induced increases in thecoefficient of filtration and the wet-to-dry lung weight ratio, inhibited increases in the rate of increase of lactate dehydrogenase activity and tumor necrosis factor a in the perfusate, and
abrogated the decrease in nitric oxide metabolites in the perfusate. No difference was found between the SEVO-IR and ISO-IR groups.
Conclusion: Isoflurane and sevoflurane administered before ischemia can attenuate IR-induced injury in isolated rat lungs.

在缺血前使用异氟烷-七氟烷可减轻兔肺的缺血再灌注损伤

背景：吸入麻醉药对缺血再灌注损伤的肺的作用尚不明确，本文的作者对异氟烷及七氟烷对孤立鼠肺模型I/R损伤的影响进行了研究。

方法：将离体鼠肺分为四组：对照组（n=6）:灌注120min,没有缺血。IR组（n=6）:终止灌注并进行通气60min,其后又进行60min的再灌注。七氟烷-IR组（n=6）和异氟烷-IR组(n=6):现给予30min1MAC的七氟烷或异氟烷，随后停止灌注60，最后再进行60min的再灌注。检测肺脏的滤过系数（Kfc），灌注液中乳酸脱氢酶活性（LDH）、TNF-α及NO代谢产物（亚硝酸盐+硝酸盐）浓度，肺脏的干湿重比值。

结果：IR导致肺脏的滤过系数（与基线相比，再灌注60min后其升高约7倍），干湿重比值，LDH活性及TNF-α均明显升高，同时灌注液中NO代谢产物明显降低。在缺血前使用1MAC的异氟烷或七氟烷可明显减轻IR导致的肺脏滤过系数及干湿重比值增加，抑制灌注液中LDH活性及TNF-α浓度的增加，同时消除灌注液中NO代谢产物的减少。七氟烷-IR组与异氟烷-IR组相比无明显差异。