| Objective:With the developed cardiopulmonary surgical techniques,lung ischemiareperfusion injury (LIRI)still is a hard work.While clinical preventing researcheshaven't got ideal progressions now.Administrating anesthetics during surgery is animportant element,some researches have found that the chlorine group inhalationanesthetics preconditioning have protective effects for LIRI.But there are somedifferent opinions,and the anesthetics postconditioning research is rare in theliterature.So it is important to performing more researches on the effects of inhalationanesthetics to LIRI.By setting the rat model of LIRI and administrating sevofluraneor isoflurane before and after ischemia,we try to compare the protective effects ofthem,and further reveal the possible mechanisms of these methods,so as to providetheoretical evidences for the corrective selection of anesthetics in clinical anesthesiaand surgery,and develop a new routine for organ protection.Method:180 healthy SD rats were randomly divided into 6 groups (n=6).①Shamgroup (C group):the left pulmonary hilum was dissociated after thoracotomy withoutocclusion and mechanically ventilated to the end;②Ischemia Reperfusion group (I/Rgroup):the left pulmonary hilum was occluded for 45min and reperfused;③Isoflurane-Preconditioning group (ISO-Pre group):administing 1MAC isoflurane(1.4%)30min before occlusion,others similar to I/R group;④Isoflurane-Postconditioning group (ISO-Pos group):administing 1MAC isoflurane30min accompanied by reperfusion;⑤Sevoflurane-Preconditioning group (SEV-Pregroup):administing 1MAC sevoflurane (2.1%)30min before the occlusion;⑥Sevoflurane-Postconditioning group (SEV-Pos group):administing 1MACsevoflurane 30min accompanied by reperfusion.At the end of experiment,each groupsacrifice 6 rats at reperfused 0min,30min,60min,120min,240min respectively,thenget arterial blood,lung tissue and bronchoalveolar lavage fluid (BALF)samples.Theparameters include artery blood oxygen pressure,amount of protein,white bloodcell differential counts,expression of tumor necrosis factors a (TNF-α),interleukin(IL-1),and IL-6 in BALF,the activity of myeloperoxidase (MPO)and theexpression of TNF-α,IL-1,and IL-6 in lung tissures,the expression of adhesion molecules CD11b,CD31,CD54,CD62L were detected.Apoptotic index wasmeasured by TUNEL assay.Using light microscope and electron microscopeinvestigate pathological changes of lung.Results:With the increasing of reperfusion stage,all test groups show apparent lunginjury changes,arterial blood oxygen pressure decreasing,the expression of MPO,TNF-α,IL-1,IL-6,and amount of protein,white blood cell differential countincreasing apparently.the expression of TNF-α,IL-1,IL-6,and adhesion moleculesCD1 lb,CD31,CD54,CD62L in BALF increasing also.Comparing with I/R groupand C group,there are apparent statistic variances in ISO and SEV groups.In I/Rgroup,significant membrane damages of typeⅡalveolar epithelial cell,vacuolization of amellar body,and disorganization of mitochondrion were revealedby electron microscope examination.While pathological changes were slight in ISOand SEV groups.There are integrated cell membrane and no vacuolization of lamellarbody.However,there are no differences between preconditioning andpostconditioning groups.Conclusion:As commonly used inhalation anesthetics,isoflurane and sevofluranepreconditioning or postconditioning all show protective effects for the LIRI in rats.The possible protective mechanisms include inhibiting inflammatory reaction,decreasing PMN infiltration and adhesion,down-regulating expression ofinflammatory factors TNF-α,IL-1,IL-6,and adhesion molecules CD11b,CD31,CD54,CD62L in BALF,so as to alleviating systemic and local inflammatory reaction,decreasing PMN aggregation and permeability of lung.There are similar protectiveeffects between ISO and SEV groups.So we interfere that they may share the samemechanisms to develop the protective effects.
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