CAJ | 학술논문

目的　探讨还原型谷胱甘肽(GSH)预处理对单肺通气患者围手术期炎性因子和自由基的影响.方法选择30例择期行肺叶切除术的肺癌患者,按随机数字表法分为GSH组和对照组,每组15例.GSH组于麻醉诱导后单肺通气前静脉输注GSH　30　mg/kg,对照组静脉输注等量0.9％氯化钠.于麻醉诱导前(T0)、单肺通气30　min(T1)、单肺通气60　min(T2)、恢复双肺通气60　min(T3)和术后2　h(T4)采集桡动脉血,测定血浆肿瘤坏死因子(TNF)-α、白细胞介素(IL)-8、丙二醛(MDA)水平和超氧化物歧化酶(SOD)活性.结果T2～T4时两组MDA较T0时显著升高(P＜　0.05)[　GSH组T0～T4分别为(3.5±0.6)、(3.8±0.8)、(4.7±1.1)、(6.1±1.2)、(6.4±0.9)　mol/L;对照组T0～T4分别为(3.7±0.5)、(4.1±0.6)、(5.9±1.2)、(7.4±1.0)、(7.8±1.1)　mol/L],但GSH组显著低于对照组(P＜0.05).T2～T4时对照组SOD活性较T0时降低(P＜0.05),且低于GSH组(P＜0.05).T1～T4时两组TNF-α、IL-8较T0时显著升高(P＜0.05),但GSH组T2～T4时TNF-α及T1～T4时IL-8显著低于对照组(P＜0.05).结论　GSH　30　mg/kg预处理可减轻单肺通气患者肺的炎性反应及脂质过氧化程度.
목적　탐토환원형곡광감태(GSH)예처리대단폐통기환자위수술기염성인자화자유기적영향.방법선택30례택기행폐협절제술적폐암환자,안수궤수자표법분위GSH조화대조조,매조15례.GSH조우마취유도후단폐통기전정맥수주GSH　30　mg/kg,대조조정맥수주등량0.9％록화납.우마취유도전(T0)、단폐통기30　min(T1)、단폐통기60　min(T2)、회복쌍폐통기60　min(T3)화술후2　h(T4)채집뇨동맥혈,측정혈장종류배사인자(TNF)-α、백세포개소(IL)-8、병이철(MDA)수평화초양화물기화매(SOD)활성.결과T2～T4시량조MDA교T0시현저승고(P＜　0.05)[　GSH조T0～T4분별위(3.5±0.6)、(3.8±0.8)、(4.7±1.1)、(6.1±1.2)、(6.4±0.9)　mol/L;대조조T0～T4분별위(3.7±0.5)、(4.1±0.6)、(5.9±1.2)、(7.4±1.0)、(7.8±1.1)　mol/L],단GSH조현저저우대조조(P＜0.05).T2～T4시대조조SOD활성교T0시강저(P＜0.05),차저우GSH조(P＜0.05).T1～T4시량조TNF-α、IL-8교T0시현저승고(P＜0.05),단GSH조T2～T4시TNF-α급T1～T4시IL-8현저저우대조조(P＜0.05).결론　GSH　30　mg/kg예처리가감경단폐통기환자폐적염성반응급지질과양화정도.
Objective To investigate the effect of reduced ghtathione (GSH) pretreatment on inflammatory factors and oxygen free radical in patients during one-lung ventilation (OLV).Methods Thirty patients with lung cancer undergoing lung resection were divided into GSH group (15 cases) and control group ( 15 cases) by random digits table.In GSH group,GSH 30 mg/kg in normal saline 100 ml was infused after induction of anesthesia before OLV,while in control group equal volume of normal saline was infused instead of GSH.Blood samples were collected before induction of anesthesia (T0) and at 30 min(T1),60 min (T2) of OLV and 60 min of two-lung ventilation (T3) and at 2 h after operation(T4) for determination of serum tumor necrosis factor(TNF)-α,interleukin(IL)-8 and malonaldehyde(MDA) concentrations and superoxide dismutase(SOD) activity.Results The serum MDA concentrations at T2-T4 were higher than those at T0 in two groups (P＜ 0.05) [GSH group:(3.5 ± 0.6),(3.8 ± 0.8),(4.7 ± 1.1 ),(6.1 ± 1.2),(6.4 ± 0.9) mol/L at T0-T4;control group:(3.7 ±0.5),(4.1 ±0.6),(5.9 ± 1.2),(7.4 ± 1.0),(7.8 ± 1.1) mol/L at T0-T4],but GSH group was lower than control group(P＜ 0.05 ).The serum SOD activity at T2-T4 was lower than that at T0 in control group (P＜ 0.05),and lower than GSH group(P＜ 0.05).The serum TNF-α,IL-8 concentrations at T1-T4 were higher those that at T0 in two groups(P ＜ 0.05 ),the serum TNF- α concentrations at T2-T4 and IL-8 concentrations at T1-T4 in GSH group were lower than those in control group (P ＜0.05).Conclusion Pretreatment with GSH 30 mg/kg can decrease inflammatory response and lipid peroxidation during OLV.