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目的探讨吗啡预处理对兔肺缺血再灌注损伤的保护作用及其可能机制。方法24 只日本大耳白兔随机分为3组(n=8):假手术组(S组)、缺血再灌注损伤组(I-R组)和吗啡预处理组(M组)。I-R、M组通过阻断左肺门2 h及再灌注2 h造成肺缺血再灌注损伤模型,M组阻断左肺门前30 min经肺动脉注入吗啡4 mg/kg,I-R组注射等量生理盐水。S组手术操作同其他两组,但不行左肺门阻断及给药。分别在阻断左肺门前(缺血前)、再灌注5、30、60、90及120 min时测定动脉血氧分压(PaO2)、平均肺动脉压(MPAP)和气道峰压(PIP),并在缺血前、再灌注60、120min时测定血浆内皮素-1 (ET-1)浓度,实验结束时测定支气管肺泡灌洗液(BALF)中性粒细胞百分比及肺湿干重比(W/D),并行肺组织病理学检查。结果与S组比较,I-R、M组再灌注各时点PaO2下降,I-R组再灌注30-120 min 时MPAP升高,I-R、M组再灌注60-120 min时PIP升高(P<0.05);与I-R组比较,M组再灌注60-120 min时MPAP、PIP降低,PaO2升高(P<0.05)。再灌注60、120min时I-R组ET-1浓度高于M、S组(P< 0.05),M组与S组比较差异无统计学意义(P>0.05)。M组BALF中性粒细胞百分比和W/D高于S 组,低于I-R组(P<0.01)。结论吗啡4mg/kg预处理对兔肺缺血再灌注损伤具有一定的保护作用, 其机制可能与降低血浆ET-1浓度及抑制中性粒细胞功能有关。
Objective To investigate the protective effect of morphine preconditioning on lung ischemia-reperfusion injury in rabbits and its possible mechanism. Methods Twenty - four Japanese white rabbits were randomly divided into three groups (n = 8): sham operation group (S group), ischemia - reperfusion injury group (I - R group) and morphine pretreatment group (M group). IR, M group caused pulmonary ischemia-reperfusion injury by blocking the left hilar 2h and reperfusion 2h, M group of morphine 4mg / kg was injected into the pulmonary artery 30min before the left hilar anterior, IR group was injected with the same amount Physiological saline. S group surgery with the other two groups, but not the left hilar block and administration. PaO2, MPAP and PIP were measured before occlusion of the left hilar (pre-ischemic) and at 5, 30, 60, 90 and 120 min after reperfusion, respectively. , And the plasma endothelin-1 (ET-1) concentration was measured before ischemia and 60,120 minutes after reperfusion. The percentage of neutrophils in bronchoalveolar lavage fluid (BALF) and the ratio of lung wet weight to dry weight W / D), parallel lung histopathology. Results Compared with group S, the PaO2 decreased at each time point in IR and M groups, MPAP increased at 30-120 min after reperfusion in IR group, PIP increased at 60-120 min in IR and M groups (P <0.05) Compared with IR group, MPAP, PIP decreased and PaO2 increased (P <0.05) at 60-120 min in M group. The concentration of ET-1 in I-R group was higher than that in M and S groups at 60,120 min after reperfusion (P <0.05). There was no significant difference between M group and S group (P> 0.05). The percentage of BALF neutrophils and W / D in M group were higher than those in S group and I-R group (P <0.01). Conclusion Morphine 4mg / kg preconditioning may have a protective effect on lung ischemia-reperfusion injury in rabbits. The mechanism may be related to the decrease of plasma ET-1 concentration and the inhibition of neutrophil function.