García-de-la-Asunción José, García-Del-Olmo Eva, Galan Genaro, Guijarro Ricardo, Martí Francisco, Badenes Rafael, Perez-Griera Jaume, Duca Alejandro, Delgado Carlos, Carbonell Jose, Belda Javier
a Department of Anesthesiology and Critical Care , Hospital Clínico Universitario de Valencia. Instituto de Investigación Sanitaria (INCLIVA) , Spain.
b Department of Thoracic Surgery , Consorcio Hospital General Universitario de Valencia , Spain.
Redox Rep. 2016 Sep;21(5):219-26. doi: 10.1080/13510002.2015.1101890. Epub 2016 Jan 21.
During lung lobectomy, the operated lung completely collapses with simultaneous hypoxic pulmonary vasoconstriction, followed by expansion and reperfusion. Here, we investigated glutathione oxidation and lipoperoxidation in patients undergoing lung lobectomy, during one-lung ventilation (OLV) and after resuming two-lung ventilation (TLV), and examined the relationship with OLV duration.
We performed a single-centre, observational, prospective study in 32 patients undergoing lung lobectomy. Blood samples were collected at five time-points: T0, pre-operatively; T1, during OLV, 5 minutes before resuming TLV; and T2, T3, and T4, respectively, 5, 60, and 180 minutes after resuming TLV. Samples were tested for reduced glutathione (GSH), oxidized glutathione (GSSG), glutathione redox potential, and malondialdehyde (MDA).
GSSG and MDA blood levels increased at T1, and increased further at T2. OLV duration directly correlated with marker levels at T1 and T2. Blood levels of GSH and glutathione redox potential decreased at T1-T3. GSSG, oxidized glutathione/total glutathione ratio, and MDA levels were inversely correlated with arterial blood PO2/FiO2 at T1 and T2.
During lung lobectomy and OLV, glutathione oxidation, and lipoperoxidation marker blood levels increase, with further increases after resuming TLV. Oxidative stress degree was directly correlated with OLV duration, and inversely correlated with arterial blood PO2/FiO2.
在肺叶切除术中，手术侧肺完全萎陷，同时伴有低氧性肺血管收缩，随后再扩张和再灌注。在此，我们研究了肺叶切除术患者在单肺通气（OLV）期间及恢复双肺通气（TLV）后谷胱甘肽氧化和脂质过氧化情况，并探讨了其与OLV持续时间的关系。
我们对32例行肺叶切除术的患者进行了一项单中心、观察性、前瞻性研究。在五个时间点采集血样：T0，术前；T1，OLV期间，恢复TLV前5分钟；T2、T3和T4，分别在恢复TLV后5、60和180分钟。检测样本中的还原型谷胱甘肽（GSH）、氧化型谷胱甘肽（GSSG）、谷胱甘肽氧化还原电位和丙二醛（MDA）。
GSSG和MDA血水平在T1时升高，并在T2时进一步升高。OLV持续时间与T1和T2时的标志物水平直接相关。GSH血水平和谷胱甘肽氧化还原电位在T1 - T3时降低。GSSG、氧化型谷胱甘肽/总谷胱甘肽比值和MDA水平在T1和T2时与动脉血氧分压/吸入氧分数比呈负相关。
在肺叶切除术和OLV期间，谷胱甘肽氧化和脂质过氧化标志物血水平升高，恢复TLV后进一步升高。氧化应激程度与OLV持续时间直接相关，与动脉血氧分压/吸入氧分数比呈负相关。
