【摘要】 目的探讨预注依达拉奉对单肺通气开胸侧肺萎陷过程中TNF-α、IL-6和IL-10变化的影响。方法择期行单肺通气开胸手术患者32例,随机均分为依达拉奉组(E组)和对照组(C组)。所有患者行双腔支气管插管并机械通气,E组在行单肺通气前5min静脉滴注依达拉奉1mg/kg,C组以等量生理盐水等速滴注。所有患者在麻醉诱导后(T0)、单肺通气后60min(T1)、术毕(T2)和术后120min(T3)四个时点抽取动脉血5ml,测定TNF-α、IL-6、IL-10及丙二醛(MDA)、超氧化物歧化酶(SOD)水平,同时监测BP、SpO2、PETCO2、动脉血气和气道压等。结果两组患者T0时的TNF-α、IL-6及IL-10变化差异无统计学意义;两组T1～T3时TNF-α、IL-6及T2、T3时IL-10明显高于T0时(P<0.05);E组在T2、T3时TNF-α、IL-6明显低于C组(P<0.05),而IL-10组间比较差异无统计学意义。与T0时比较,T2、T3时E组SOD升高而C组降低,且E组明显高于C组(P<0.05);与T0时比较,两组患者T1～T3时MDA均明显升高,且T2、T3时E组明显低于C组(P<0.05)。结论预注依达拉奉干预,可抑制单肺通气肺萎陷过程中TNF-α、IL-6水平,减轻肺损伤早期的全身炎性反应。更多还原

【Abstract】 Objective To investigate the effects of edaravone pretreatment on TNF-α、IL-6 and IL-10 in pulmonary collapse during one lung ventilation.Methods Thirty-two patients who scheduled for thoracotomy of pulmonary collapse during one lung ventilation were randomly divided into two groups(n=16): the group pretreated with edaravone (group E) and control group (group C).All patients were mechanically ventilated after double-lumen tube endotracheal intubation. The patients in group E were received edaravone 1 mg/kg i.v. within 5 min before the one lung ventilation. In group C received equal volume of saline. Intraarterial blood were drawn after induction(T0), 60 min after one lung ventilation(T1), at the end of operation(T2)and 120 min after operation(T3)to determine the levels of TNF-α, IL-6, IL-10, malondialdehyde (MDA) and superoxide dismutase (SOD).And at the same time, BP,SpO2,PETCO2,arterial blood gases and airway pressure were monitored.Results There were no significant differences in TNF-α,IL-6 and IL-10 levels at T0 in two groups. The levels of TNF-α,IL-6 at T1-T3 and the levels of IL-10 at T2,T3 were higher than those at T0(P<0.05). Compared with group C, TNF-α,IL-6 levels in group E were significantly lower at T2,T3(P<0.05), while the levels of IL-10 were no significant differences.SOD in group E were increased at T2,T3 than those at T0, while SOD in group C were decreased, and the SOD in group E were significantly higher than those in group C (P<0.05).MDA in both the two groups were obviously increased at T1-T3 than those at T0, and the MDA in group E were significantly lower than group C at T2,T3(P<0.05).Conclusion Edaravone pretreatment could decrease TNF-α and IL-6 levels in pulmonary collapse during one lung ventilation, and attenuate the systemic inflammatory response in the early period of pulmonary injury.更多还原