氯沙坦对犬体外循环肺损伤的影响
Effect of losartan on lung injury during cardiopulmonary bypass in dogs
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摘要: 目的:研究氯沙坦对体外循环(CPB)致犬肺损伤的影响,探讨CPB致肺损伤的机制。方法:健康成年杂种犬12只,体质量(14.25±1.60)kg,雌雄不拘,采用随机数字表法分为对照组(C组)和氯沙坦组(L组)各6只。麻醉后开胸建立CPB模型。L组于CPB前30 min经股静脉注射氯沙坦1 mg/kg,C组于同时点注射等容量0.9%氯化钠注射液。分别于CPB前(T1)、主动脉阻断后45 min(T2)、主动脉开放后30 min(T3)、开放后60 min即停机时(T4)取静脉血测血管紧张素Ⅱ(AngⅡ)和丙二醛(MDA)水平;取动脉血测血气并计算T1、T4时的氧合指数(OI)和呼吸指数(RI);光镜下观察肺组织病理学改变。结果:与T1时比较,2组T2~4时血浆AngⅡ和MDA水平均明显升高(P<0.01),T4时OI降低、RI升高(P<0.05~P<0.01)。L组CPB后各时点血浆AngⅡ水平与C组差异均无统计学意义(P>0.05),但L组T4时血浆MDA水平显著低于C组(P<0.01)。L组T4时OI和RI与C组差异均无统计学意义(P>0.05),但肺损伤较C组减轻。结论:氯沙坦可阻断AngⅡ的作用,抑制氧化应激,可减轻CPB后肺损伤。Abstract: Objective: To study the effects of losartan on lung injury during cardiopulmonary bypass(CPB) in dogs,and its mechanism.Methods: Twelve adult healthy mongrel dogs,weighing(14.25±1.60) kg,were randomly divided into the control group(group C,n=6) and losartan group(group L,n=6).The CPB model of dog was established.The group L and C were intravenously injected with 1 mg/kg of losartan and 0.9% sodium chloride at 30 min before CPB,respectively.The plasma levels of angiotensinⅡ(AngⅡ) and malondialdehyde(MDA) in two groups were measured before injecting(T1),at 45 min after aortic cross-clamping(T2),and at 30 min(T3) and 60 min(T4) after aortic unclamping.The oxygenation index(OI) and respiratory index(RI) were calculated at T1 and T4,and their lung tissue structures were observed under optical microscope.Results: Compared with T1,the plasma levels of AngⅡ and MDA in two groups at T2-4 increased significantly(P<0.01),and the OI and RI at T4 in two groups decreased and increased,respectively(P<0.05-P<0.01).The differences of the plasma levels of AngⅡ in all time points between Group L and C were not statistical significance(P>0.05).At T4,the level of MDA in group L was significantly lower than that in group C(P<0.01).The differences of the OI and RI at T4 between two groups were not statistical significance(P>0.05),and the lung injury in group L was lighter than that in group C at T4.Conclusions: Losartan can block the role of AngⅡ,and restrain oxidative stress,which can prevent the lung injury caused by CPB.
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Key words:
- lung injury /
- cardiopulmonary bypass /
- losartan /
- dog
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