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目的观察依达拉奉在肺癌胸腔镜手术中单肺通气时相关肺损伤的保护作用。方法选择2013年1月至2015年12月于河北北方学院附属第二医院择期行胸腔镜肺叶切除手术的肺癌患者60例,随机将其分为对照组和依达拉奉组,每组30例。依达拉奉组患者于手术前30 min开始静脉滴注依达拉奉30 mg(溶于100 m L生理盐水),30 min内滴注完毕,对照组以同样方式静脉滴注100 m L生理盐水。2组患者分别于切皮前和单肺通气结束时取肘静脉血样,检测血清肿瘤坏死因子-α(TNF-α)、白细胞介素-8(IL-8)水平;于开胸单肺通气开始时、肺叶离断时取肿瘤边缘正常肺组织,测定肺水通道蛋白1(AQP1)、肺水通道蛋白4(AQP4)表达,并对2组患者检测结果进行比较。结果单肺通气结束时2组患者血清TNF-α、IL-8水平较肺通气开始时明显升高(P<0.05);依达拉奉组患者单肺通气结束时血清TNF-α、IL-8水平较对照组明显下降(P<0.05)。与开胸单肺通气时比较,肺叶切除时2组患者肺组织AQP1和AQP4表达明显增高(P<0.05);与对照组比较,依达拉奉组患者肺叶切除时肺组织AQP1和AQP4表达明显降低(P<0.05)。结论依达拉奉预先给药可降低肺癌胸腔镜肺叶切除术单肺通气时TNF-α、IL-8水平,抑制AQP1、AQP4的表达。
Objective To observe the protective effect of edaravone on lung injury associated with one lung ventilation during thoracoscopic surgery in lung cancer. Methods Sixty patients with lung cancer undergoing thoracoscopic lobectomy undergoing elective thoracoscopic lobectomy in the Second Affiliated Hospital of Hebei North University from January 2013 to December 2015 were randomly divided into control group and edaravone group, 30 cases in each group . In edaravone group, edaravone 30 mg (dissolved in 100 m L saline) was intravenously injected 30 min before the operation, and the infusion was completed within 30 min. In the same way, the control group received intravenous infusion of 100 mL physiological saline brine. The two groups of patients received elbow venous blood samples before the cephalad and at the end of the single lung ventilation to detect the levels of tumor necrosis factor-α (TNF-α) and interleukin-8 (IL-8) Initially, lung tissue was taken from the normal lung tissue at the margin of the lung to determine the expression of AQP1 and AQP4, and the results of the two groups of patients were compared. Results Serum levels of TNF-α and IL-8 in the two groups at the end of single lung ventilation were significantly higher than those at the beginning of lung ventilation (P <0.05). Serum levels of TNF-α and IL- 8 levels were significantly lower than the control group (P <0.05). Compared with the control group, the expression of AQP1 and AQP4 in the lung tissue of the two groups was significantly increased at the time of lobectomy (P <0.05). Compared with the control group, the expression of AQP1 and AQP4 in the lung tissue of the edaravone group was significantly lower than that of the control group Decreased (P <0.05). Conclusion Edaravone preconditioning can reduce the level of TNF-α and IL-8 and the expression of AQP1 and AQP4 in lung cancer undergoing one-lung ventilation with thoracoscopic lobectomy.