CAJ | 학술논문

目的探讨N-乙酰半胱氨酸对体外循环(CPB)诱发犬肺损伤的影响.方法成年犬36只,雌雄不拘,体重15 ～ 16 kg,采用随机数字表法,将其随机分为2组(n=18):CPB组(C组)和N-乙酰半胱氨酸组(N组).右锁骨下动脉和右心房分别插管,制备CPB模型,N组于CPB前即刻静脉注射N-乙酰半胱氨酸150mg/kg,然后以20 mg·kg-1·h-1速率静脉输注至CPB结束后60 min；C组给予等容量生理盐水.分别于CPB前、CPB结束后30、60 min时采集动脉血样,进行动脉血气分析,计算呼吸指数和氧合指数；然后处死动物,取肺组织,测定MDA含量、SOD活性和转化生长因子-β1( TGF-β1) mRNA表达；光镜和电镜下观察肺组织病理学结果.结果与C组比较,N组呼吸指数和肺组织MDA含量降低,氧合指数和肺组织SOD活性升高,TGF-β1 mRNA表达下调(P＜0.05或0.01),肺组织病理学损伤程度明显减轻.结论 N-乙酰半胱氨酸可减轻CPB诱发犬肺损伤,其机制与减轻脂质过氧化反应,下调肺组织TGF-β1表达有关.
목적 탐토N-을선반광안산대체외순배(CPB)유발견폐손상적영향.방법 성년견36지,자웅불구,체중15 ～ 16 kg,채용수궤수자표법,장기수궤분위2조(n=18):CPB조(C조)화N-을선반광안산조(N조).우쇄골하동맥화우심방분별삽관,제비CPB모형,N조우CPB전즉각정맥주사N-을선반광안산150mg/kg,연후이20 mg·kg-1·h-1속솔정맥수주지CPB결속후60 min；C조급여등용량생리염수.분별우CPB전、CPB결속후30、60 min시채집동맥혈양,진행동맥혈기분석,계산호흡지수화양합지수；연후처사동물,취폐조직,측정MDA함량、SOD활성화전화생장인자-β1( TGF-β1) mRNA표체；광경화전경하관찰폐조직병이학결과.결과 여C조비교,N조호흡지수화폐조직MDA함량강저,양합지수화폐조직SOD활성승고,TGF-β1 mRNA표체하조(P＜0.05혹0.01),폐조직병이학손상정도명현감경.결론 N-을선반광안산가감경CPB유발견폐손상,기궤제여감경지질과양화반응,하조폐조직TGF-β1표체유관.
Objective To investigate the effect of N-acetylcysteine on lung injury induced by cardiopulmonary bypass(CPB) in dogs.Methods Thirty-six healthy adult mongrel dogs of both sexes weighing 15-16 kg were randomly assigned into 2 groups (n =18 each):CPB group (group C) and N-acetylcysteine group(group N).Lung injury was produced by CPB.In group N N-acetylcysteine 150 mg/kg was injected iv immediately before CPB,followed by infusion at 20 mg· kg-1 · h-1 until 60 min after termination of CPB.Blood samples were taken from femoral artery before CPB (T0,baseline),30 and 60 min after termination of CPB (T1,T2 ).Oxygenation index ( OI =PaO2 ÷ FiO2 ) and respiratory index (RI =PA-(a) DO2 ÷ PaO2 ) were calculated.Six animals were sacrificed at each time point.Lung specimens were obtained for microscopic examination,and determination of transforming growth factor-β1 (TGF-β1) mRNA expression,MDA content and SOD activity.Results CPB significantly increased RI,MDA content and TGF-β1 mRNA expression and decreased OI and SOD activity at T1 and T2 as compared with the baseline values at T0 in group C.N-acetylcysteine administered before and during CPB significantly attenuated CPB-induced above changes in OI,RI,MDA content,SOD activity and TGF-β1 mRNA expression.Microscopic examination showed that N-acetylcysteine significantly ameriorated CPB-induced lung damage.Conclusions N-acetylcysteine administered before and during CPB can attenuate CPB-induced lung injury by inhibiting lipid peroxidation response and down-regulating TGF-β1 expression.