右美托咪定对单肺通气患者血浆IL-8、IL-10及肺组织AQP1表达的影响

目的评价右美托咪定对单肺通气(one lung ventilation,OLV)患者血浆IL-8、IL-10及肺组织水通道蛋白(aquaporin,AQP)1表达的影响。方法择期行肺癌根治术患者40例,男23例,女17例,年龄40~75岁,ASAⅠ或Ⅱ级,采用随机数字表法将患者均分为两组:对照组(C组)和右美托咪定组(D组)。麻醉诱导前10 min,D组静注右美托咪定1μg/kg,随后以0.5μg·kg-1·h-1的速率输注至手术结束前30min,C组采用同样的方法静注等容量的生理盐水。于OLV前即刻(T1)、OLV 30min(T2)、60min(T3)、120min(T4)、恢复双肺通气后30min(T5)、术后2h(T6)取桡动脉血,测定血浆IL-8和IL-10的浓度。于OLV前即刻、肺叶离体时取肺组织,测定AQP1的表达。结果 T3~T6时C组及T3~T5时D组IL-8浓度,T2~T5时两组IL-10浓度明显高于T1时(P0.05);D组T3~T6时IL-8浓度明显低于,T2~T5时IL-10浓度明显高于C组(P0.05)。C组肺叶离体时AQP1表达明显低于OLV前即刻和D组(P0.05)。结论给予负荷量1μg/kg的右美托咪定,随后以0.5μg·kg-1·h-1的速率持续输注,可以降低单肺通气患者全身炎症反应,上调肺组织AQP1表达。

Effects of dexmedetomidine on plasma IL-8,IL-10 levels and lung AQP1 expression in patients undergoing one lung ventilation

Objective To investigate the effects of dexmedetomidine on plasma IL-8,IL-10 level and lung AQP1 expression in patients undergoing one lung ventilation(OLV).Methods Forty patients,ASA Ⅰ or Ⅱ,scheduled for lung cancer radical surgery were randomly divided into two groups:control group (group C)and dexmedetomidine group (group D).In group D,dexmedetomi-dine 1 μg/kg (initial dose)was given over more than 10 min before anaesthesia induction,followed by continuous infusion at 0.5 μg·kg-1 ·h-1 until 30 min before the end of operation.In group C,the e-qual volume of normal saline was infused.Blood samples were collected at immediately before OLV (T1 ),30 (T2 ),60 (T3 ),120 (T4 )min of OLV,30 min after lung inflate (T5 )and 2 h after opera-tion (T6 )for determination of plasma IL-8 and IL-10 levels.Lung tissues were obtained at T1 for de-termination of AQP1 expression.Results Compared with the value at T1 ,plasma IL-8 levels in group C at T3-T6 and in group D at T3-T5 were increased,plasma IL-10 levels were increased in both groups at T2-T5 (P <0.05).Compared with group C,plasma IL-8 levels at T3-T6 were decreased and plasma IL-10 levels at T2-T5 were increased in group D (P <0.05).Compared with the value at immediately before OLV,the expression of AQP1 was decreased at the time of lobectomy of lungs in group C (P<0.05).Compared with group C,the expression of AQP1 at the time of lobectomy of lungs in group D was increased (P <0.05).Conclusion Dexmedetomidine 1 μg/kg followed by continuous infusion at 0.5 μg·kg-1 ·h-1 can reduce inflammatory response,up-regulate the expression of AQP1 in pa-tients undergoing OLV.