硝普钠对乳猪体外循环中肺损伤的保护作用

目的 探讨硝普钠预处理对乳猪体外循环(CPB)中的肺保护作用.方法 20只幼猪,数字随机分为实验组(A组)及对照组(B组).A组CPB前30min股静脉滴入硝普钠(20μg·kg-1·min-1)至实验结束,B组滴入生理盐水.CPB前(T1)、主动脉开放(T2)、CPB后5 min(T3)、20 min(T4)、40 min(T5)、60 min(T6)时点测定气道峰压(Ppk).T1、T3、T6时点行动脉血气分析、血浆TNF-a、IL-6、IL-8、IL-10检测及肺动脉、左心房血中性粒细胞检测.实验结束后,切取3块肺组织行肺湿干比(W/D)测定、光镜及电镜组织形态学观察.结果 中性粒细胞滞留率T6[A组(0.48±0.21),B组(0.77±0.29)]、血清炎症因子水平:TNF-α浓度T3[A组(45.20±14.00)pg/ml,B组(71.19±11.65)pg/ml]、IL-6浓度T3[A组(33.38±9.72)pg/ml,B组(46.09±12.12)pg/ml]、IL-8浓度T3及T6[A组(27.84±11.96)pg/ml、(24.94±1 4.24)pg/ml,B组(56.73±14.78)pg/ml、(40.99±7.94)pg/ml]和IL-10浓度T3[A组(37.88±7.79)pg/ml,B组(27.62±11.53)pg/ml]、氧合指数(OI)T3[A组(463.05±40.50)%,B组(382.62±80.01)%]及动脉-肺泡氧分压比率(Pao2/PAo2)T3及T6[A组(0.75±0.10)、(0.76±0.07),B组(0.56±0.12)、(0.60±0.07)]、气道峰压(Ppk)T3[A组(16.57±1.51)mmHg,B组(23.00±2.00mmHg]以及肺湿干比(W/D)[A组(0.21±0.03),B组(0.27±0.04)].A组与B组相比,差异均有统计学意义.光镜、电镜检查显示A组肺损伤明显减轻.结论 CPB期间,硝普钠预处理能抑制炎症因子上调,减轻急性炎症反应,改善肺功能.

Abstract：

Objective To investigate the protective effects of sodium nitroprusside on lung injury induced by cardiopulmonary bypass (CPB). Methods Twenty piglets were randomly divided into group A (n = 10) and group B (n = 10). The piglets of the group A were administered with sodium nithe end of the experiment. The piglets of group B were continuously injected with saline. Peak pressure (Ppk) of the airway was measured before CPB (T1), at the time releasing aortic cross-clamp,and 5 min (T3), 20 min (T4), 40 min (T5), 60 min (T6) after CPB. The blood gases, neutrophils count and TNF-α, IL-8, IL-6 and IL-10 levels were measured at T1, T3, and T6. Lung tissue was collected to measure the wet to dry weight ratio (W/D). The morphologic changes of the lung were also studied. Results At T3, TNF-α, IL-6, and IL-8 levels, Ppk and W/D ratios of group A were significantly lower than those of group B 33.38 ± 9. 71 pg/ml vs 46. 09 ± 12. 12 pg/ml, 27. 84 ±11. 96 pg/ml vs 40. 99 ± 7. 94 pg/ml, 16. 57 ± 1.51 mmHg vs 23. 00 ± 2. 00 mmHg, 0. 21 ± 0. 03 vs 0. 27 ± 0. 04,respectively). At T3, IL-10, oxygenation index, and alveolar-arterial oxygen ratio of group A were significantly higher than those of group B (37. 88 ± 7. 79 pg/ml vs 27. 62 ± 11. 53 pg/ml, 463. 05 ±40. 50% vs 382. 62 ± 80. 01 %, 0. 75 ± 0. 10 vs 0. 56 ± 0. 12). At T6, the neutrophil sequestration,IL8 level, and alveolar-arterial oxygen ratio of group A were significantly higher than those of group B (0. 48 ± 0. 21 vs 0. 77 ± 0. 29, 24. 94 ± 14. 24 pg/ml vs 40. 99 ± 7. 94 pg/ml, 0. 76 ± 0. 07 vs 0. 60 ±0. 07). Lung morphology study also showed group A had less injury. Conclusions Sodium nitroprusside protects lung from injury by suppressing inflammation on piglets with cardiopulmonary bypass.

Sodium nitroprusside reduces lung injury after cardiopulmonary bypass

Objective To investigate the protective effects of sodium nitroprusside on lung injury induced by cardiopulmonary bypass (CPB). Methods Twenty piglets were randomly divided into group A (n = 10) and group B (n = 10). The piglets of the group A were administered with sodium nithe end of the experiment. The piglets of group B were continuously injected with saline. Peak pressure (Ppk) of the airway was measured before CPB (T1), at the time releasing aortic cross-clamp,and 5 min (T3), 20 min (T4), 40 min (T5), 60 min (T6) after CPB. The blood gases, neutrophils count and TNF-α, IL-8, IL-6 and IL-10 levels were measured at T1, T3, and T6. Lung tissue was collected to measure the wet to dry weight ratio (W/D). The morphologic changes of the lung were also studied. Results At T3, TNF-α, IL-6, and IL-8 levels, Ppk and W/D ratios of group A were significantly lower than those of group B 33.38 ± 9. 71 pg/ml vs 46. 09 ± 12. 12 pg/ml, 27. 84 ±11. 96 pg/ml vs 40. 99 ± 7. 94 pg/ml, 16. 57 ± 1.51 mmHg vs 23. 00 ± 2. 00 mmHg, 0. 21 ± 0. 03 vs 0. 27 ± 0. 04,respectively). At T3, IL-10, oxygenation index, and alveolar-arterial oxygen ratio of group A were significantly higher than those of group B (37. 88 ± 7. 79 pg/ml vs 27. 62 ± 11. 53 pg/ml, 463. 05 ±40. 50% vs 382. 62 ± 80. 01 %, 0. 75 ± 0. 10 vs 0. 56 ± 0. 12). At T6, the neutrophil sequestration,IL8 level, and alveolar-arterial oxygen ratio of group A were significantly higher than those of group B (0. 48 ± 0. 21 vs 0. 77 ± 0. 29, 24. 94 ± 14. 24 pg/ml vs 40. 99 ± 7. 94 pg/ml, 0. 76 ± 0. 07 vs 0. 60 ±0. 07). Lung morphology study also showed group A had less injury. Conclusions Sodium nitroprusside protects lung from injury by suppressing inflammation on piglets with cardiopulmonary bypass.