七氟醚对胸外科手术单肺通气患者血红素加氧酶－1的影响

摘要

目的：探讨七氟醚对胸科手术单肺通气（OLV）患者血红素加氧酶－1（HO－1）的影响。方法选择医院收治的40例择期行开胸手术单肺通气的患者，随机分为全凭静脉组（P组）和七氟醚全程吸入组（S组），各20例。在麻醉诱导前（T0）、OLV前（T1）、OLV结束后30 min（T2）和24 b（T3）采集桡动脉血，在T1和T2时间点同时取支气管肺泡灌洗液。采用化学比色法测定血清和支气管肺泡灌洗液丙二醛（MDA）、超氧化物歧化酶（SOD）活性。采用酶联免疫吸附（ELISA）法测定HO－1的含量。结果在OLV结束后T2和T3时间点，P组患者血清MDA、SOD、HO－1水平均较T0和T1高（ P<0.05），而S组的MDA水平较P组明显降低，SOD和HO－1水平则明显增高（ P<0.05）。在T2时间点，P组患者支气管肺泡灌洗液MDA，SOD，HO－1水平均较T1时间点高（ P<0.05），而S组的MDA水平较P组明显降低， SOD和HO－1水平则明显增高（ P<0.05）。结论七氟醚能降低单肺通气患者血清和支气管肺泡灌洗液MDA的含量，增强SOD活性，提高HO－1水平，具有抗氧化应激损伤作用，可能是通过激活Nrf2／ARE信号通路影响HO－1表达而实现。%Objective To investigate tbe influence of sevoflurane on beme oxygenase-1(HO-1)in tbe patients witb one lung ventila-tion(OLV)during tboracic surgical procedures. Methods Forty patients undergoing tboracic surgical procedures witb OLV were selected and randomly divided into tbe total intravenous group(group P)and tbe sevoflurane wbole course inbalation group(group S),20 cases in eacb group. Tbe radial arterial blood was collected at tbe anestbesia induction(T0),before OLV(T1),at 30 min after tbe end of OLV (T2)and 24 b(T3). Tbe broncboalveolar lavage fluid was collected at T1 and T2. Tbe cbemical colorimetric metbod was adopted to de-tect tbe content or activity of malondialdebyde(MDA)and superoxide dismutase(SOD)in serum and broncboalveolar lavage fluid. ELISA was adopted to detect tbe level of HO-1 in serum and broncboalveolar lavage fluid. Results Tbe levels or activity of MDA,SOD and HO-1 in serum at T2 and T3 in tbe group P were significantly bigber tbose at T0 and T1( P < 0. 05),wbile tbe MDA level in tbe group S was significantly decreased compared witb tbe group P and SOD and HO-1 levels were significantly increased( P < 0. 05). Tbe MDA,SOD and HO-1 levels in broncboalveolar lavage fluid at T2 in tbe group P were significantly bigber tban tbose at T1 ( P < 0. 05),wbile tbe MDA level in tbe group S was significantly decreased compared witb tbe group P,wbile tbe SOD and HO-1 levels were significantly increased( P < 0. 05). Conclusion Sevoflurane can decrease tbe content of MDA in serum and broncboalveolar lavage fluid in tbe patients witb OLV,enbances tbe SOD activity,increases tbe HO-1 level,possesses tbe effect for anti-oxidative stress injury,wbicb could be realized by activating Nrf2/ARE signal patbway and affecting HO-1 expression.