异丙酚对猕猴失血性休克所致再灌注肺损伤的保护作用

目的 研究异丙酚对猕猴失血性休克与复苏过程中所致再灌注肺损伤的保护作用。方法 将12只猕猴随机分为对照组（n=6)和异丙酚组（n=6)。异丙酚组在放血前10min用计算机靶控输注技术使猕猴血浆异丙酚浓度达到8ng/L并维持此水平。对两组动物用相同方法制作失血性休克模型,维持休克2h后复苏,回输全部自体抗凝血及2倍放血量的生理盐水,复苏后2h处死动物取肺组织进行干湿重测定及病理检查。分别于放血前、休克2h和复苏2h测定血流动力学参数,并取静脉血标本测定丙二醛（MDA）、超氧化物歧化酶（SOD）和乳酸（LA）含量。结果 对照组猕猴在休克2h和复苏2h时的平均肺动脉压（MPA）、肺血管阻力指数（PVRI）均明显高于异丙酚组（P＜0．05）,异丙酚组猕猴的MDA、LA总体水平均明显低于对照组（P＜0．05）,对照组动物肺组织湿重／干重比值明显大于异丙酚组（P＜0．05）,病理观察发现异丙酚组肺组织水肿较对照组轻。结论 异丙酚对猕猴缺血再灌注所引起的肺组织损伤有一定保护作用。

Effect of propofol on protecting Rhesus macaques from reperfusion lung injury during hemorrhagic shock and resuscitation

OBJECTIVE: To investigate the protective efficacy of propofol against lung injury during hemorrhagic shock and resuscitation among Rhesus macaques. METHODS: Two healthy rhesus monkeys (Rhesus macaques) were killed and their lungs were taken out as samples of normal lung. Two healthy rhesus monkeys were made animal models of hemorrhagic shock and then were killed with their lungs taken out as samples of hemorrhagic shock lung. Another 12 healthy rhesus monkeys were randomly divided into two groups of six animals: propofol group (administered with propofol to a plasma concentration of 8 mg/L by target control infusion with computer before hemorrhagic shock) and control group. The monkeys were bled through the right femoral vein till the mean arterial pressure remained at the shock level of 40 mm Hg +/- 5 mm Hg. Two hours later, the total amount of bled blood and normal saline of the volume 2 times the volume of blood loss were reinfused into the animals quickly. Another 2 hours later hemodynamic parameters were measured, and blood samples were taken for measurement of malondialdehyde (MDA), superoxidedismutase (SOD) and lactate before bleeding, two hours after shock appeared, and 2 hours after resuscitation. The monkeys were killed 2 hours after resuscitation; their lungs were taken for pathologic examination and determination of water-to-dry weight ratio. RESULTS: The lungs of the 2 normal rhesus monkeys were normal with the W/D of 5.545 +/- 0.191. There is not remarkable change in the lung constitution of the 2 shock rhesus monkeys with a W/D ratio of 5.655 +/- 0.474. The mean pulmonary arterial pressure (MPA) and pulmonary vascular resistance index (PVRI) of the control group 2 hours after hemorrhagic shock and 2 hours after resuscitation were 17.00 +/- 4.42 and 22.83 +/- 5.11 respectively, both significantly higher than those of the propofol group (10.83 +/- 2.71 and 18.66 +/- 3.38, both P < 0.05). The pulmonary vascular resistance index (PVRI) of the control group 2 hours after hemorrhagic shock and 2 hours after resuscitation were 458.67 +/- 91.92 and 260.17 +/- 57.85 respectively, both significantly higher than those of the propofol group (258.67 +/- 63.02 and 159.17 +/- 47.98 respectively, both P < 0.05). The W/D ratio of the control group 2 hours after resuscitation was significantly higher than that of the propofol group (P < 0.05). The pulmonary edema of the control group was more serious than that of the propofol group by light microscopy and electron microscopy. CONCLUSION: Propofol remarkably relieves the lung injury occurring during hemorrhagic shock and resuscitation stage by ameliorating pulmonary circulation.