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目的 探讨利多卡因对失血性休克大鼠肺损伤的保护作用。方法 80只雄性Wistar大鼠建立失血性休克模型后,随机分为四组,假手术组(Ⅰ组,n=8)、休克组(Ⅱ组,n=8)、生理盐水组(Ⅲ组,n=32)、利多卡因组(Ⅳ组,n=32)。Ⅰ组于假手术后,Ⅱ组于休克60 min,Ⅲ、Ⅳ组分别于复苏开始后2、4、8、12 h,测定中性粒细胞(PMNs)表面粘附分子CD11b/CD18表达、肺组织中髓过氧化物酶(MPO)活性,并采用光镜和透射电镜观察肺组织的病理学改变。结果 与Ⅰ组比较,Ⅲ组、Ⅳ组复苏后各时点PMNs表面CD11b/CD18表达均升高(P<0.01),Ⅱ组差异无显著性(P>0.01),Ⅱ组、Ⅲ组、Ⅳ组复苏后各时点肺组织中MPO活性升高(P<0.05或0.01)。与Ⅲ组比较,Ⅳ组复苏后同一时点、Ⅰ组、Ⅱ组PMNs表面CD11b/CD18表达及肺组织中MPO活性降低(P<0.01)。结论 小剂量利多卡因可以抑制失血性休克大鼠PMNs表面CD11b/CD18的表达,减少PMNs在肺组织中的浸润,从而减轻肺损伤。
Objective To investigate the protective effect of lidocaine on lung injury in hemorrhagic shock rats. Methods Eighty male Wistar rats were randomly divided into four groups: sham operation group (group Ⅰ, n = 8), shock group (group Ⅱ, n = 8), normal saline group (group Ⅲ, n = 32), lidocaine group (group IV, n = 32). In sham-operated groupⅠ, the expression of CD11b / CD18 on the surface of neutrophils (PMNs) was measured at 60 min after shock in groups Ⅲ, Ⅳ and Ⅳ, respectively. The activity of myeloperoxidase (MPO) in the tissue was observed. The pathological changes of the lung tissue were observed by light microscope and transmission electron microscope. Results Compared with group Ⅰ, the expression of CD11b / CD18 on PMNs in group Ⅲ and group Ⅳ were significantly increased at each time point after resuscitation (P <0.01), but there was no significant difference between group Ⅱ and group Ⅲ After the resuscitation, MPO activity in lung tissue increased at each time point (P <0.05 or 0.01). Compared with group Ⅲ, the expression of CD11b / CD18 on PMNs in group Ⅰ and group Ⅱ and MPO activity in lung decreased at the same time after Ⅳ group resuscitation (P <0.01). Conclusion Low-dose lidocaine can inhibit the expression of CD11b / CD18 on the surface of PMNs in hemorrhagic shock rats and reduce the infiltration of PMNs in the lung tissue, thus reducing lung injury.