中华麻醉学杂志
中華痳醉學雜誌
중화마취학잡지
CHINESE JOURNAL OF ANESTHESIOLOGY
2014年
11期
1399-1401
,共3页
右美托咪啶%清醒镇静%创伤和损伤%内毒素血症%急性呼吸窘迫综合征,成人
右美託咪啶%清醒鎮靜%創傷和損傷%內毒素血癥%急性呼吸窘迫綜閤徵,成人
우미탁미정%청성진정%창상화손상%내독소혈증%급성호흡군박종합정,성인
Dexmedetomidine%Conscious sedation%Wounds and injuries%Endotoxemia%Respiratory distress syndrome,adult
目的 评价右美托咪定镇静对创伤-内毒素“二次打击”诱发大鼠急性肺损伤的影响.方法 清洁级SD雄性大鼠24只,6～8周龄,体重150～ 200 g,采用随机数字表法,将其分为3组(n=8):对照组(C组)、二次打击组(T组)和右美托咪定组(D组).T组和D组采用钳夹法造成双侧股骨中段闭合骨折,骨折后即刻D组静脉输注右美托咪定2.5 μg·kg-1 ·h-1,C组和T组输注等容量生理盐水,输注8h.骨折后4h时T组和D组静脉注射脂多糖2.5 mg/kg.腹腔皮下接动态血糖监测系统感应探头,用于监测组织间液葡萄糖浓度,记录骨折后24 h内血糖浓度,计算日内平均血糖波动幅度(MAGE).于骨折后24h时采集动脉血样,进行血气分析,然后取肺组织,测定肺组织TNF-α和IL-6的含量,并进行肺损伤评分.结果 与C组比较,T组和D组MAGE、PaCO2、肺组织TNF-α和IL-6含量及肺损伤评分升高,pH值和PaO2降低(P＜0.01);与T组比较,D组MAGE、肺组织TNF-α和IL-6含量及肺损伤评分降低,pH值和Pa02升高(P＜0.05),PaCO2差异无统计学意义(P＞0.05).结论 右美托咪定镇静可减轻创伤-内毒素“二次打击”诱发大鼠急性肺损伤,其机制与减轻应激反应及炎性反应有关.
目的 評價右美託咪定鎮靜對創傷-內毒素“二次打擊”誘髮大鼠急性肺損傷的影響.方法 清潔級SD雄性大鼠24隻,6～8週齡,體重150～ 200 g,採用隨機數字錶法,將其分為3組(n=8):對照組(C組)、二次打擊組(T組)和右美託咪定組(D組).T組和D組採用鉗夾法造成雙側股骨中段閉閤骨摺,骨摺後即刻D組靜脈輸註右美託咪定2.5 μg·kg-1 ·h-1,C組和T組輸註等容量生理鹽水,輸註8h.骨摺後4h時T組和D組靜脈註射脂多糖2.5 mg/kg.腹腔皮下接動態血糖鑑測繫統感應探頭,用于鑑測組織間液葡萄糖濃度,記錄骨摺後24 h內血糖濃度,計算日內平均血糖波動幅度(MAGE).于骨摺後24h時採集動脈血樣,進行血氣分析,然後取肺組織,測定肺組織TNF-α和IL-6的含量,併進行肺損傷評分.結果 與C組比較,T組和D組MAGE、PaCO2、肺組織TNF-α和IL-6含量及肺損傷評分升高,pH值和PaO2降低(P＜0.01);與T組比較,D組MAGE、肺組織TNF-α和IL-6含量及肺損傷評分降低,pH值和Pa02升高(P＜0.05),PaCO2差異無統計學意義(P＞0.05).結論 右美託咪定鎮靜可減輕創傷-內毒素“二次打擊”誘髮大鼠急性肺損傷,其機製與減輕應激反應及炎性反應有關.
목적 평개우미탁미정진정대창상-내독소“이차타격”유발대서급성폐손상적영향.방법 청길급SD웅성대서24지,6～8주령,체중150～ 200 g,채용수궤수자표법,장기분위3조(n=8):대조조(C조)、이차타격조(T조)화우미탁미정조(D조).T조화D조채용겸협법조성쌍측고골중단폐합골절,골절후즉각D조정맥수주우미탁미정2.5 μg·kg-1 ·h-1,C조화T조수주등용량생리염수,수주8h.골절후4h시T조화D조정맥주사지다당2.5 mg/kg.복강피하접동태혈당감측계통감응탐두,용우감측조직간액포도당농도,기록골절후24 h내혈당농도,계산일내평균혈당파동폭도(MAGE).우골절후24h시채집동맥혈양,진행혈기분석,연후취폐조직,측정폐조직TNF-α화IL-6적함량,병진행폐손상평분.결과 여C조비교,T조화D조MAGE、PaCO2、폐조직TNF-α화IL-6함량급폐손상평분승고,pH치화PaO2강저(P＜0.01);여T조비교,D조MAGE、폐조직TNF-α화IL-6함량급폐손상평분강저,pH치화Pa02승고(P＜0.05),PaCO2차이무통계학의의(P＞0.05).결론 우미탁미정진정가감경창상-내독소“이차타격”유발대서급성폐손상,기궤제여감경응격반응급염성반응유관.
Objective To evaluate the effect of dexmedetomidine sedation on acute lung injury induced by trauma and endotoxemia "two-hit" in rats.Methods Twenty-four adult male Sprague-Dawley rats,aged 6-8 weeks,weighing 150-200 g,were randomized into 3 groups (n =8 each) using a random number table:control group (group C),"two-hit" group (group T) and dexmedetomidine group (group D).Bilateral middle femoral shaft fractures were produced using hemostatic forceps.In group D,dexmedetomidine 2.5 tμg· kg-1· h-1 was infused via the caudal vein immediately after fractures,while the equal volume of normal saline was infused for 8 h in C and T groups.Lipopolysaccharide 2.5 mg/kg was injected via the caudal vein at 4 h after fractures in T and D groups.All the animals were monitored for 24 h with a continuous glucose monitoring system.Blood glucose concentrations were recorded within 24 h after fractures,and mean amplitude of glucose excursions (MAGE) was calculated.The arterial blood samples were collected at 24 h after fractures for blood gas analysis.The lungs were then harvested for determination of tumor necrosis factor-α (TNF-α) and interleukin-6 (IL-6) contents in lung tissues and for microscopic examination of pathological changes which were scored.Results Compared with group C,MAGE,PaCO2,TNF-α and IL-6 contents and pathological scores were significantly increased,and pH value and PaO2 were decreased in T and D groups.Compared with group T,MAGE,TNF-α and IL-6 contents and pathological scores were significantly decreased,and pH value and PaO2 were increased,and no significant change was found in PaCO2 in D group.Conclusion Dexmedetomidine sedation can mitigate acute lung injury induced by trauma and endotoxemia "two-hit",and the mechanism is related to reduced stress and inflammatory responses in rats.
