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| 利多卡因对脓毒症大鼠肺损伤的影响 |
| Effect of lidocaine on lung injury in septic rats |
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| DOI：10.12089/jca.2021.12.013 |
| 中文关键词: 利多卡因 脓毒症 血管内皮 糖萼 多配体聚糖1 乙酰肝素酶 |
| 英文关键词: Lidocaine Sepsis Vascular endothelium Glycocalyx Syndecan-1 Heparanase |
| 基金项目:国家自然科学基金（81860345） |
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| 中文摘要: |
目的 研究利多卡因对脓毒症大鼠肺损伤的影响。
方法 选择清洁级SD成年雄性大鼠30只，2月龄，体重250～300 g。采用随机数字表法将大鼠分为三组：假手术组（S组）、盲肠结扎穿孔组（C组）和利多卡因组（L组），每组10只。S组仅打开腹腔后缝合，C组和L组采用盲肠结扎穿孔法（CLP）建立脓毒症模型。L组建立脓毒症模型后即刻给予利多卡因的负荷剂量10 mg/kg，后尾静脉持续泵注利多卡因10 mg·kg-1·h-1，持续3 h；S组和C组注射等量等渗氯化钠溶液。于建模后24 h处死大鼠，打开腹腔，采集下腔静脉血5 ml，采用ELISA法检测血清TNF-α、糖萼成分多配体聚糖1（Syndecan-1）、乙酰肝素酶（Heparanase）浓度。处死大鼠后采集腹主动脉血0.5 ml进行血气分析，记录PaO2和PaCO2。腹主动脉取血之后迅速开胸，取双肺组织，左肺组织计算肺组织湿/干重比，右肺组织采用透射电镜观察血管内皮糖萼结构。
结果 与S组比较，C组血清TNF-α、Syndecan-1和Heparanase浓度均明显升高（P<0.05），PaO2和PaCO2明显降低（P<0.05），C组肺组织湿/干重比明显升高（P<0.05）。与C组比较，L组血清TNF-α、Syndecan-1和Heparanase浓度均明显降低（P<0.05），PaO2和PaCO2明显升高（P<0.05），肺组织湿/干重比明显降低（P<0.05）。S组糖萼连续，分布均匀，结构致密；C组糖萼不连续，出现大量中断，分布不均匀，糖萼结构明显疏松；L组糖萼不连续，出现少量中断，分布不均匀，糖萼结构较疏松，但中断程度、分布不均匀程度以及疏松程度均轻于C组。
结论 利多卡因可以减少炎性因子释放、改善肺血管通透性、减轻脓毒症肺损伤，保留糖萼结构完整性。 |
| 英文摘要: |
Objective To study the effect of lidocaine on lung injury in septic rats.
Methods Thirty adult male SD rats of clean grade, aged 2 months, weighing 250-300 g, were selected. The rats were divided into three groups by random number table: sham operation group (group S), cecal ligation and puncture group (group C) and lidocaine group (group L), 10 rats in each group. In group S, only the abdominal cavity was opened and sutured, and in group C, the sepsis model was established by cecal ligation and puncture (CLP). In group L, a loading dose of lidocaine 10 mg/kg was given immediately after the sepsis model was established, and lidocaine 10 mg·kg-1·h-1 was continuously pumped into the posterior tail vein for 3 hours. The same amount of isotonic NaCl was given in groups S and C instead. 24 hours after CLP, the rats were sacrificed, the abdominal cavity was opened, 5 ml of blood was collected from the vein, and the serum concentrations of inflammatory factor TNF-α, glycocalyx components Syndecan-1, and Heparanase were measured by ELISA. Immediately after the rats were sacrificed, 0.5 ml of abdominal aortic blood was collected for blood gas analysis, and PaO2 and PaCO2 were recorded. After blood sampling from the abdominal aorta, the chest was rapidly opened, both lung tissues were taken, the wet/dry weight ratio of lung block was calculated for the left lung tissue, and the vascular endothelial glycocalyx structure was observed under transmission electron microscope for the right lung tissue.
Results Compared with group S, the concentrations of serum TNF-α, Syndecan-1 and Heparanase were significantly increased in group C (P < 0.05), PaO2 and PaCO2 were significantly decreased in group C (P < 0.05), the wet/dry weight ratio of lung tissue was significantly increased in group C (P < 0.05). Compared with group C, the concentrations of serum TNF-α, Syndecan-1 and Heparanase concentrations were significantly decreased in group L (P < 0.05), PaO2 and PaCO2 were significantly increased in group L (P < 0.05), and the wet/dry weight ratio of lung tissue was significantly decreased in group L (P < 0.05). The glycocalyx was continuous, evenly distributed, and densely structured in group S. The glycocalyx was discontinuous, having a large number of interruptions and a loose structure, unevenly distributed in group C. The glycocalyx was discontinuous, with a small number of interruptions, uneven distribution, and loose glycocalyx structure in group L, but the degree of interruptions, uneven distribution, and looseness were milder than those in group C.
Conclusion Lidocaine can reduce the release of inflammatory factors, improve pulmonary vascular permeability, reduce septic lung injury and preserve the structural integrity of glycocalyx. |
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