利多卡因后处理对大鼠肺缺血／再灌注损伤的影响

目的研究利多卡因后处理对大鼠肺缺血／再灌注损伤（lung ischemia／reperfusion injury，LI／RI）的作用并探讨其可能的机制。方法80只SD大鼠按随机数字表法分为4组，每组20只：假手术组（Sham组）、缺血，再灌注组（ischemia／reperfusion，VR）组]、单纯缺血后处理组（ischemic preconditioning，IPC）组]、利多卡因后处理组（Lidocaine组）。采用夹闭左肺门45min、然后复灌2h的方法建立在体肺棵模型。Lidocaine组再灌注即刻开始以4mg·kg-1·h-1泵入利多卡因，持续再灌注2h。观察肺组织病理学改变，检测支气管肺泡灌洗液（bronchoalveolar lavage fluid，BALF）中肺表面活性蛋白A（pulmonary surfatcantassociated proteinA，SP-A）、肺组织SP-AmRNA和SP-A的浓度。结果肺组织病理学观察发现Lidocaine组的肺水肿和白细胞渗出较I／R组明显减轻。再灌注后Lidocaine组与IPC组BALF中SP-A的浓度分别为（8．68±0．41）和（6．56±0．38），明显高于I／R组（4．42±0．21），差异有统计学意义（P〈0．05）；肺组织SP-AmRNA的浓度分别为（1．49±0．12）和（1．26±0．10），明显高于I／R组（1．05扣．11），差异有统计学意义（P〈0．05）；肺组织SP-A的浓度分别为（72．5±2．9）和（41．3±3．1），明显高于I／R组（26．8±2．3），差异有统计学意义（P〈0．05）；Lidocaine组与IPC组比较，BALF中SP-A、肺组织SP-AmRNA和SP-A的浓度明显升高，差异有统计学意义（P〈0．05）。结论利多卡因后处理可使大鼠I／R肺中SP-A的表达上调、分泌增加，可减轻肺水肿，且效果优于单纯IPC，对在体大鼠LI／RI有保护作用。

Effects of lidocaine postconditioning on lung ischemia/reperfusion injury in rats

Objective To observe the effects of lidocaine postconditioning on lung ischemia/reperfusion injury （LI/RI） and explore its possible mechanism. Methods According to the random number table, eighty adult SD rats were randomized to 4 groups： Sham group, ischemia/reperfusion （I/R） group, ischemic postconditioning （IPC） group and lidocaine postconditioning （Lidoeaine） group. The pulmonary ischemia/repeffusion model was established by occlusion of the left hilum of lung for 45 min and the reperfusion was taken by removing the clamp for 2 h. At the moment of reperfusion, lidocaine 4 mg/kg was injected as apriming dose following a continuous rate of 4 mg·kg-1 ·h -1. Observed the changes of histopathological and detect pulmonary surfatcant- associated protein A（SP-A） of bronchoalveolar lavage fluid（BALF）, SP-A mRNA of lung tissue and SP-A concentrations. Results Compared with I/R group, lidocaine postconditioning on pulmonary injury following I/R pulmonary edema and leukocyte exudation was significantly reduced the concentration of SP-A in BALF were（ 8.68±0.41 ） and （6.56±0.38） in lidocaine postconditioning group and IPC group ,respectively. It was significantly higher than I/R group which was （4.42±0.21）（P〈0.05 ）. The concentration of SP-A mRNA in lung tissue in Lidocaiue group （1.49±0.12） and IPC group（1.26±0.10） were higher than I/R group（1.05±0.11）（P〈0.05）. The concentration of SP-A in lung tissue in Hdocaine group （72.5±2.9） and IPC group （41.3±3.1） were higher than I/R group （26.8±2.3） （P〈0.05）. Compared with IPC group, the concentration of SP-A in BALF,SP-A mRNA in lung tissue and SP-A in Lidocaine group are significantly higher, the difference was statistically significant （P〈0.05）. Conclusions Lidocaine posteonditioning exerts a protective effect on LI/RI administered in the beginning of reperfusion. The effect may lay on increasing expression of SP-A, secretion, reduce pulmonary edema and it is better than IPC.