尼可地尔抑制塌陷肺损伤的作用

发布时间：2018-06-20 04:48

本文选题：尼可地尔 + 单肺通气　；参考：《临床麻醉学杂志》2017年12期

【摘要】：目的探讨尼可地尔抑制单肺通气时塌陷肺损伤的作用及可能机制。方法选用清洁级日本大耳白兔24只。随机分为S组(双肺通气+开胸)、C组(单肺通气+开胸+生理盐水)、N组(单肺通气+开胸+尼可地尔)和J组(单肺通气+开胸+尼可地尔+格列苯脲),每组6只。予静脉麻醉诱导后,行气管切开置入自制双腔气管导管实施机械通气。配合听诊法、气泡试验法和直接观察法将动物进行单肺通气和双肺通气,模拟开胸手术。取非通气肺保存处理,测湿/干重比(W/D)和丙二醛(MDA)浓度。采用Western blot法检测非通气侧肺组织蛋白激酶B(Akt)、p-Akt和NF-κB蛋白含量。结果 N组、C组和J组的W/D和MDA浓度明显高于S组(P0.05),但N组明显低于C组(P0.05),J组明显高于N组(P0.05)。N组p-Akt蛋白含量和p-Akt/Akt明显高于S组、C组和J组(P0.05)。C组NF-κB蛋白含量明显高于S组和N组(P0.05),N组明显低于J组(P0.05)。结论尼可地尔在家兔单肺通气时对非通气侧肺的塌陷及复张有保护作用,可能通过PI3K/Akt通路发挥作用,并且通过下调NF-κB减轻肺损伤。
[Abstract]:Objective to investigate the effect and possible mechanism of nicorandil in inhibiting collapse lung injury during single lung ventilation. Methods 24 clean grade Japanese white rabbits were selected. Group S was randomly divided into two groups: group C (single lung ventilation with normal saline) and group J (single lung ventilation with open chest nicorandil) with 6 rats in each group. After induction of intravenous anesthesia, tracheotomy was performed and self-made double-chamber tracheal catheter was placed for mechanical ventilation. Combined with auscultation, bubble test and direct observation, single lung ventilation and double lung ventilation were performed to simulate thoracotomy. The wet / dry weight ratio (W / D) and malondialdehyde (MDA) MDAs were measured after non-ventilated lung preservation. The protein levels of protein kinase B (BK) and protein kinase (K) -Akt and NF- 魏 B in non-ventilated lung tissue were detected by Western blot. Results the levels of WR D and MDA in group N were significantly higher than those in group S, but the protein contents of p-Akt and p-Akt/Akt in group N were significantly higher than those in group C and group J (P 0.05) and p-Akt/Akt were significantly higher than those in group S and group J (P 0.05. 05. C). The content of NF- 魏 B protein in group N was significantly higher than that in group C and group J, but the protein content of NF- 魏 B was significantly higher in group N than that in group C and group J, respectively. Group S and group N were significantly lower than group J (P 0.05). Conclusion nicorandil has protective effect on collapsing and retensioning of non-ventilatory side lung during one-lung ventilation in rabbits. It may play a role through PI3K / Akt pathway and attenuate lung injury by down-regulation of NF- 魏 B.
【作者单位】：苏州大学附属第一医院麻醉科;南通大学附属医院麻醉科;南通大学医学院;
【分类号】：R614

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