氯胺酮对哮喘大鼠机械通气肺损伤的保护作用_医学论文.docVIP

氯胺酮对哮喘大鼠机械通气肺损伤的保护作用_医学论文 氯胺酮对哮喘大鼠机械通气肺损伤的保护作用_医学论文 作者：金立达，蒋柳明，林丽娜，王万铁【摘要】 目的:探讨氯胺酮对哮喘大鼠机械通气肺损伤的影响。方法:40只SD大鼠制备慢性哮喘模型后随机分成4组（n=10）：对照组（N组），哮喘大鼠旷置8 h，不行机械通气；机械通气组(A组)，采用容量控制机械通气模式（Vt=10 ml/kg，f=30 次/min）通气8 h；不同剂量氯胺酮干预组(K1、K2组)，机械通气前K1组静脉注射氯胺酮5 mg/kg，K2组静脉注射氯胺酮10 mg/kg，余同A组。实验结束后处死大鼠，测量肺湿干重比（W/D）及支气管肺泡灌洗液（BALF）中蛋白含量、白细胞（WBC）计数、肿瘤坏死因子-α(TNF-α)、白细胞介素-6(IL-6)及一氧化氮（NO）含量，观察肺组织病理形态学变化。结果:与N组比较，A组、K1组、K2组W/D增加，BALF中蛋白含量、白细胞计数、TNF-α、IL-6、NO含量增高（均0.05），病理损伤程度加重；与A组比较，K1组、K2组W/D降低，BALF中蛋白含量、白细胞计数、TNF-α、IL-6、NO含量下降（均0.05），病理损伤程度减轻；K2组蛋白含量、白细胞计数低于K1组（均0.05），其余指标K1、K2两组间差异无显著性（Pgt0.05）。结论:氯胺酮可抑制TNF-α、IL-6及NO的释放，从而对哮喘大鼠机械通气所致肺损伤起到保护作用。 【关键词】 氯胺酮；机械通气；肺损伤；哮喘；大鼠 Abstract: Objective:To investigate the effect of ketamine on ventilator-induced lung injury (VILI) in asthmatic rats. Methods: Forty Sprague-Dawley (SD) asthmatic rats were anesthetized, tracheotomized and randomly divided into four groups（n=10）: group N received normal saline iv. but not mechanically ventilation, the other three groups were ventilated for 8 h （Vt=10 ml/kg, f=30 bpm）. Group A received normal saline iv, group K1 received ketamine iv in a bolus of 5 mg/kg and group K2 received ketamine iv in a bolus of 10 mg/kg. The lungs were removed for determination of the wet to dry weight ratio (W/D), TNF-α, IL-6, NO and protein content in bronchoalveolar lavage fluid (BALF). Total white blood cells (WBC) in BALF were counted and lung histopathology were assessed among four groups. Results: The content of TNF-α, IL-6, NO, protein of BALF, together with the value of W/D were significantly higher in group A than that in group N, K1 and K2, while decreased in group K1 and K2 than that in, group A (0.05). A large quantity of WBC were found in BALF of group A, while the amount of WBC was decreased in group K1 and K2 than that in group A (0.05). Histopathologic findings demonstrated more infiltrating neutrophils and destructive changes of the alveolar wall in group A than that in other groups. The content of protein, the qua