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| 尼可地尔抑制塌陷肺损伤的作用 |
| Effects of nicorandil on lung injury induced by collapse |
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| DOI：10.12089/jca.2017.12.1211 |
| 中文关键词: 尼可地尔 单肺通气 肺保护 丙二醛 磷脂酰肌醇-3-激酶 |
| 英文关键词: Nicorandil One-lung ventilation Lung protection MDA PI3K |
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| 中文摘要: |
目的 探讨尼可地尔抑制单肺通气时塌陷肺损伤的作用及可能机制。
方法 选用清洁级日本大耳白兔24只。随机分为S组(双肺通气+开胸)、C组(单肺通气+开胸+生理盐水)、N组(单肺通气+开胸+尼可地尔)和J组(单肺通气+开胸+尼可地尔+格列苯脲), 每组6只。予静脉麻醉诱导后, 行气管切开置入自制双腔气管导管实施机械通气。配合听诊法、气泡试验法和直接观察法将动物进行单肺通气和双肺通气, 模拟开胸手术。取非通气肺保存处理,测湿/干重比（W/D）和丙二醛（MDA）浓度。采用Western blot法检测非通气侧肺组织蛋白激酶B(Akt)、p-Akt和NF-κB蛋白含量。
结果 N组、C组和J组的W/D和MDA浓度明显高于S组(P<0.05), 但N组明显低于C组(P<0.05), J组明显高于N组(P<0.05)。N组p-Akt蛋白含量和p-Akt/Akt明显高于S组、C组和J组(P<0.05)。C组NF-κB蛋白含量明显高于S组和N组(P<0.05), N组明显低于J组(P<0.05)。
结论 尼可地尔在家兔单肺通气时对非通气侧肺的塌陷及复张有保护作用, 可能通过PI3K/Akt通路发挥作用, 并且通过下调NF-κB减轻肺损伤。 |
| 英文摘要: |
Objective To investigate the effects and possible mechanisms of nicorandil on lung injury of the collapsed lung in one-lung ventilation.
Methods Twenty-four clean Japanese big-ear rabbits were randomly divided into sham group (group S) (two-lung ventilation+thoracotomy), negative control group (group C) (one-lung ventilation+thoracotomy+saline), nicorandil group (group N) (one-lung ventilation+thoracotomy+nicorandil) and antagonist group (group J) (one-lung ventilation+thoracotomy+nicorandil+glyburide) equally. Mechanical ventilation was implemented through self-made double-lumen endotracheal tube after intravenous induction through ear marginal vein. Intravenous maintenance medicine was infused by trace injection pump after anesthesia induction. Thoracic surgery was simulated through one-lung or two-lung ventilation determined by auscultation, bubble test and direct observation. Then wet and dry weight ratio (W/D) and content of MDA were measured after non-ventilatory lung was processed and preserved. The expression of Akt, p-Akt and NF-κB protein in non-ventilatory lung tissue were detected by Western-blot in all groups.
Results In respects of W/D and content of MDA, the other three groups had significant differences compared with group S (P<0.05). It was significantly lower in group N than in group C (P<0.05), and it was significantly higher in group J than in group N (P<0.05). The expressions of p-Akt protein and p-Akt/Akt in group N were significantly higher than those in group S and group C (P<0.05). Those of group J were significantly lower than group N (P<0.05). Compared with group S, the expression of NF-κB protein in group C was significantly higher (P<0.05). That of group N was significantly lower than that of group C (P<0.05). But that in group J was higher than that in group N (P<0.05).
Conclusion Nicorandil has a protective effect on the collapse and inflation of non-ventilatory lung in rabbits under one lung ventilation, acting on mitoKATP through PI3K/Akt, and down-regulating NF-κB to reduce IR-induced lung injury. |
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