七氟醚后处理下调RAGE抑制犬体外循环肺缺血/再灌注损伤

目的探讨七氟醚后处理对犬体外循环肺缺血/再灌注损伤的效果及晚期糖基化终末产物受体(receptor for ad-vanced glycosylation end products,RAGE)在此过程中的作用。方法 12只健康犬依据主动脉开放后是否吸入七氟醚随机分为两组:对照组(control,n=6)在主动脉开放后常规机械通气和实验组(test,n=6)在主动脉开放后吸入1MAC七氟醚,持续10min。在开胸后即刻(T1)、主动脉开放90min实验结束前(T2)留取肺组织标本和肺静脉血标本。标检测肺组织湿干重比(wet/dry weight,W/D);比色法检测肺组织髓过氧化物酶活性(myeloperoxidase activity,MPO);光镜观察并盲法评分比较肺组织病理学变化;分别采取RT-PCR方法、Western blot检测肺组织RAGE的表达;酶联免疫吸附法检测血清白介素6(IL-6)和肿瘤坏死因子α(TNF-α)含量。结果两组相比,实验组肺组织W/D、MPO、肺损伤评分、RAGE基因表达和蛋白表达、IL-6和TNF-α含量在T2时较对照组降低(P<0.05);组内比较,所有指标实验结束时均较基础值明显升高(P<0.05)。结论七氟醚后处理对体外循环缺血/再灌注导致的肺损伤具有一定的保护作用,可能与其抑制RAGE合成与激活有关。

Sevoflurane postconditioning protects the lung against ischemia-reperfusion injury with CPB by downregulating RAGE

Aim To observe the protective effects of sevoflurane postconditioning on lung ischemic reperfusion injury with CPB and the mechanism of RAGE in this process.Methods Twelve canines were randomized into two groups:control group(n=6)received mechanical respiration as clinical cardiopulmonary bypass did after aortic declamping;test group(n=6)received mechanical respiration with 1MAC sevoflurane for 10 min.Lung injuries(which was marked by wet/dry weight,myeloperoxidase activity,tissue pathology,serum IL-6,and TNF-α)and expression of receptor for advanced glycosylation end products were analyzed.Results Compared with the control group,W/D,MPO activity,pathological scores,IL-6,TNF-α and the expression of RAGE by RT-PCR and western blot in test group were significantly lower(P<0.05).Conclusion Sevoflurane postconditioning is protective on the lung ischemia-reperfusion injury with CPB.The protective effects are related with its downregulation of RAGE.