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抑制诱导型一氧化氮合酶可改善大鼠肠缺血再灌注后的肺损伤。

Inhibition of inducible nitric oxide synthase ameliorates lung injury in rats after gut ischemia-reperfusion.

作者信息

Uchida Kotaro, Mishima Shiro, Ohta Sho-Ichi, Yukioka Tetsuo

机构信息

Department of Emergency and Critical Care Medicine, Tokyo Medical University, Tokyo, Japan.

出版信息

J Trauma. 2007 Sep;63(3):603-7. doi: 10.1097/TA.0b013e3181271b0b.

Abstract

BACKGROUND

Gut hypoperfusion is considered to be a critical event for organ failure during severe surgical insults. The mechanism of remote organ injury after intestinal ischemia-reperfusion (I/R) may involve the excessive nitric oxide (NO) production; however, its role has been controversial. We sought to determine whether a selective inducible NO synthase inhibitor, aminoguanidine (AG), ameliorates pulmonary microvascular injury after superior mesenteric artery occlusion.

METHODS

Anesthetized rats underwent superior mesenteric artery occlusion for 30 minutes and reperfusion for 6 hours (I/R) or sham operation (control). Another set of animals undergoing I/R received an AG at the end of the ischemia. Pulmonary vascular permeability was assessed by measuring tissue retention of Evans Blue dye that binds albumin. The plasma was harvested and NO2/NO3 (end products of NO) was measured. The bacterial cultures of the mesenteric lymph node of animals were performed to estimate the gut bacterial translocation after injury.

RESULTS

The concentration of NO2/NO3 of plasma in the I/R group was higher than that of the control (p < 0.05). The lung-to-plasma Evans Blue dye ratio in the I/R group was also higher than that of the control (p < 0.01). Treatment with the AG prevented this lung injury induced by the gut I/R. The incidences of gut translocation were not significantly different between the I/R and AG groups.

CONCLUSIONS

Increased lung vascular permeability elicited by gut I/R was significantly attenuated with inhibition of an inducible NO release by AG. Control of bacterial translocation was not needed to prevent lung injury in this model.

摘要

背景

肠道低灌注被认为是严重手术创伤期间器官衰竭的关键事件。肠缺血再灌注(I/R)后远隔器官损伤的机制可能涉及一氧化氮(NO)产生过多;然而,其作用一直存在争议。我们试图确定选择性诱导型一氧化氮合酶抑制剂氨基胍(AG)是否能改善肠系膜上动脉闭塞后的肺微血管损伤。

方法

将麻醉的大鼠进行肠系膜上动脉闭塞30分钟并再灌注6小时(I/R)或假手术(对照)。另一组接受I/R的动物在缺血结束时给予AG。通过测量与白蛋白结合的伊文思蓝染料的组织潴留来评估肺血管通透性。采集血浆并测量NO2/NO3(NO的终产物)。对动物的肠系膜淋巴结进行细菌培养以评估损伤后肠道细菌移位情况。

结果

I/R组血浆中NO2/NO3的浓度高于对照组(p<0.05)。I/R组肺与血浆伊文思蓝染料比值也高于对照组(p<0.01)。AG治疗可预防肠道I/R诱导的这种肺损伤。I/R组和AG组之间肠道移位的发生率无显著差异。

结论

AG抑制诱导型NO释放可显著减轻肠道I/R引起的肺血管通透性增加。在该模型中,预防肺损伤无需控制细菌移位。

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