|
Objective: intestinal ischemia-reperfusion (intestinal ischenaia-reperfusion, I / R) due to acute blood loss, shock, DIC, intestinal obstruction, severe multiple trauma caused. I / R is not only caused by intestinal damage, they can still cause damage distant organs, or even multi-system organ failure (multiple system organ failure MSOF), in which lung injury caused by acute respiratory distress syndrome (acute respiratory distress syndrome, ARDS) is the most prominent. Propofol is commonly used intravenous anesthetics, due to its rapid induction, rapid recovery and other advantages are increasingly widely used in clinical. Ulinastatin separation and purification of glycoproteins from adult male fresh urine are protease inhibitors, plasmin, trypsin, granulocyte elastase, hyaluronic enzymes variety of enzyme inhibition, the other having lysosomal membrane stability, inhibit the release of lysosomal enzymes, inhibit MDF produce oxygen free radicals, inhibit excessive superoxide generation and the elimination of the superoxide inhibit the release of inflammatory mediators. Both alone have oxygen free radicals, inhibiting the inflammatory response, the present study was to confirm propofol combined with ulinastatin on intestinal ischemia-reperfusion (I / R) lung injury in rats. Methods: 30 male SD rats were randomly divided into five groups, fasted 12h, free access to water. Establishment of model: rat peritoneal injection of 1% sodium pentobarbital 45mg/kg anesthesia, supine fixed on the operating table, cut the neck and right groin hair, three times the surgical field with povidone-iodine disinfection Shop sterile drapes. Median along the neck skin do 1.5cm long incision, blunt dissection of the muscular layer of the glass the minute hand, exposing the left common carotid artery. Cord ligation of common carotid artery with a No. 1 first telecentric side, and then the artery clip the occluding artery proximal end, placed in a heparin-treated 22 of the trocar and the fixed sleeve position, connecting the pressure sensor through the HP 78354C multifunction the physiological monitor mean arterial blood pressure; equally isolated right femoral vein to trocar placement on the 24th for infusion and administration. Tracheotomy followed by DH-140-type animal ventilator mechanical ventilation; ventral midline incision into the abdominal cavity, free arterioles of the superior mesenteric artery (SMA), with non-invasive micro-artery clipping (bowel color quickly by rosy pale, pulse disappeared prove artery occlusion exact) and the incision was sutured 60min after the original incision into the abdomen to release the arterial folder to restore the blood supply 120min. Sham group [I group, according to the method of production of the above animal models, but the artery (SMA) occlusion] intestinal I / R group [II group, according to the method of production of the above animal models, blocking the artery (SMA) 10min before Chest was opened immediately after the animals were killed, the separation of the left lung lavage collected lavage fluid and lung tissue protein concentration in bronchoalveolar lavage fluid (BALF) was measured; separation of the right lung measuring lung wet / dry weight, lung tissue malondialdehyde (MDA), superoxide dismutase (SOD) activity; ultrastructural changes of lung tissue transmission electron microscope, optical microscope to observe the pathological changes of the lung tissue. Results: Propofol combined ulinastatin than monotherapy significantly improved lung tissue ultrastructural changes, and closer to the sham group, reduce intestinal I / R after bronchial lavage fluid protein concentration, lung tissue malondialdehyde content, lung wet / dry weight, increased superoxide dismutase activity (P lt; 0.05 or 0.01). Conclusion: propofol and Ulinastatin, separate medication can alleviate lung injury after rat intestinal I / R, and the combination medication more significant effect than medication alone.
|