Kwak Sang Hyun, Choi Jeong Il, Park Jong Tae
Department of Anesthesiology and Pain Medicine, Chonnam National University Medical School, 8 Hakdong, Dong-gu, Gwangju 501-757, Korea. s
J Korean Med Sci. 2004 Feb;19(1):55-61. doi: 10.3346/jkms.2004.19.1.55.
This study was undertaken to clarify the effects of propofol on endotoxin-induced acute lung injury. Rabbits were randomly assigned to one of four groups. Each group received intravenous infusion of saline only, saline and Escherichia coli endotoxin, propofol (1 mg/kg bolus, then 5 mg/kg/hr) and endotoxin, or propofol (4 mg/kg bolus, then 20 mg/kg/hr) and endotoxin respectively. Infusion of saline or propofol was started 0.5 hr before the infusion of saline or endotoxin, and continued for 6 hr thereafter. The lungs of rabbits were ventilated with 40% oxygen. Mean blood pressure, heart rate, arterial oxygen tension (PaO2), and peripheral blood leukocyte and platelet count were recorded. The wet/dry (W/D) weight ratio of lung and lung injury score were measured, and analysis of bronchoalveolar lavage fluid (BALF) was done. Endotoxin decreased PaO2, and peripheral blood leukocyte and platelet count. And it increased W/D ratio of lung, lung injury score and leukocyte count, percentage of PMN cells, concentration of albumin, thromboxane B2 and IL-8 in BALF. Propofol attenuated all these changes except the leukocyte count in peripheral blood. In conclusion, propofol attenuated endotoxin-induced acute lung injury in rabbits mainly by inhibiting neutrophil and IL-8 responses, which may play a central role in sepsis-related lung injury.
本研究旨在阐明丙泊酚对内毒素诱导的急性肺损伤的影响。将兔子随机分为四组。每组分别接受仅静脉输注生理盐水、生理盐水和大肠杆菌内毒素、丙泊酚(1mg/kg负荷剂量,然后5mg/kg/小时)和内毒素,或丙泊酚(4mg/kg负荷剂量,然后20mg/kg/小时)和内毒素。在输注生理盐水或内毒素前0.5小时开始输注生理盐水或丙泊酚,并在此后持续6小时。用40%氧气对兔子的肺进行通气。记录平均血压、心率、动脉血氧分压(PaO2)以及外周血白细胞和血小板计数。测量肺的湿/干(W/D)重量比和肺损伤评分,并对支气管肺泡灌洗液(BALF)进行分析。内毒素降低了PaO2以及外周血白细胞和血小板计数。并且它增加了肺的W/D比值、肺损伤评分以及BALF中的白细胞计数、PMN细胞百分比、白蛋白浓度、血栓素B2和IL-8。丙泊酚减轻了所有这些变化,但外周血白细胞计数除外。总之,丙泊酚主要通过抑制中性粒细胞和IL-8反应减轻内毒素诱导的兔子急性肺损伤,这可能在脓毒症相关的肺损伤中起核心作用。