布比卡因影响小鼠肺泡上皮液体清除的作用机制研究

摘要

Objective To explore the effects of bupivacaine on alveolar fluid clearance ( AFC) in mice and its mechanism. Methods Total of 48 mice were divided into six groups, 0. 3 mL of iso-osmotic 5 % bovine serum albumine (BSA) was instilled intratracheally after anaesthesia. BSA of the control group, amiloride group, bupivacaine group, bupivacaine + amiloride group, terbutaline group, and bupivacaine + terbutaline group, include one of the followings; blank, 1 mmol/L amiloride, 1 mmol/L bupivacaine, 1 mmol/L bupivacaine + 1 mM amiloride, 0. 1 mM terbutaline and 1 mM bupivacaine +0.1 mM terbutaline, respectively. AFC was measured using bovine serum albumin protein assays in the extraction fluid after 30 min. Results Compared with the control group, AFC in the bupivacaine group , amiloride group and bupivacaine + amiloride group decreaseed significantly ( all P <0. 05) , no significant difference were found between the former two groups; Compared with the control group, AFC in the terbutaline group and bupivacaine + terbutaline group increased significantly,especially in the former group. Conclusions The reduction of AFC following application of bupivacaine may be the crucial step of the pathogenesis of pulmonary edema and terbutaline can reverse the inhibitory effects of bupivacaine.%目的 探讨布比卡因对小鼠肺泡液体清除率( AFC)的影响及机制.方法 将48只小鼠分为六组.麻醉后经气管插管注入0.3 mL等渗5％小牛血清白蛋白(BSA),对照组、阿米组、布比组、布比+阿米组、特布组及布比+特布组BSA液中分别含有空白液、1 mmol/L阿米洛利、1 mmol/L布比卡因、1 mmol/L布比卡因+1 mmol/L阿米洛利、0.1 mmol/L特布他林及1 mmol/L布比卡因+0.1 mmol/L特布他林.注射30 min后负压吸取肺泡内液体,测定小牛血清白蛋白浓度,计算AFC.结果 与对照组比较,布比组、阿米组及布比+阿米组AFC明显降低,P均＜0.05；特布组AFC明显增加,特布+布比组AFC明显高于特布组.结论 临床上布比卡因所致急性肺水肿的发生可能与AFC降低,抑制肺泡上皮钠通道有关；特布他林能拮抗布比卡因对AFC的抑制作用.