Effect Of Combination Of Propofol And Ulinastatin On Pulmonary Injury After Intestinal Ischemia-reperfusion In Rats

Objective: Intestinal ischemia-reperfusion (I/R) may be due to acute blood loss, shock, DIC, intestinal obstruction, severe multiple trauma and other factors. I/R not only induced intestinal damages, but also leaded to the damage of distant organs and even multi-system organ failure (multiple system organ failure MSOF), in which the lung injury caused by acute respiratory distress syndrome (acute respiratory distress syndrome, ARDS) is the most prominent. Propofol was commonly used in intravenous anesthetics, because of its rapid emergence and quick palinesthesia had been widely used in clinical. Ulinastatin is a glycoprotein which is separated from fresh urine of adult males , is a protease inhibitor which inhibits the plasmin, trypsin, neutrophil elastase, hyaluronic acid, and a variety of enzymes, and the other with stability of lysosomal membranes. To investigate the effect of propofol combined with ulinastatin on pulmonary injury after intestinal ischemia-reperfusion (I/R) in rats.Methods: Male SD 30 rats were fasting 12h, free drinking water. The establishment of model: After intraperitoneal injecting of 1% sodium pentobarbital 45mg/kg anesthesia, fixed its supinely on the operating table, cut the neck and right groin hair, disinfected the operative field three times with povidone-iodine, spreaded out the sterile hole towel. To do 1.5cm long incision center along the neck skin, dissected muscle with the minute hand, exposed the left common carotid artery. Ligated the common carotid artery ligation of the distal end with the line of 1, cut the proximal artery by arterial clamp, and then fixed into the 22th heparin-treated trocar , connected pressure sensors function and monitored the mean arterial blood pressure by HP 78354C physiological monitoring ; isolated the right femoral vein and fixed into trocar 24 for infusion and drug delivery. Connected DH-140 type animal ventilator followed by tracheotomy; got into the abdominal cavity by abdominal midline incision, freed the superior mesenteric artery (SMA), clamped by non-invasive micro-artery, ( The intestine color paled rapidly from red , small artery pulse disappeared which to prove the exact occlusion). Sutured the incision, got into the abdomen by the original incision 60min later, loosed artery clamp, restored the blood supply of 120min. Male SD 30 rats were randomly divided into 5 groups: sham operation group (groupⅠ), intestinal I/R group (groupⅡ), ulinastatin group (groupⅢ), propofol group (groupⅣ) and combination of propofol and ulinastatin ( groupⅤ). (n=6 each). In groupⅢ, ulinastatin 50 000μ/kg was injected intravenously. In groupⅣ, propofol was infused at 8 mg?kg-1?h-1 using a micro pump. The protein concentration in bronchoalveolar lavage fluid (BALF), wet/dry (W/D) lung weight ratio, malondialdehyd (MDA) content in lung tissues and superoxide dismutase (SOD) activity. The change in ultrastructure was observed with transmission electron microscope.Results: The combination of propofol and ulinastatin can better improve the change in ultrastructure than either of them alone though decreasing the protein concentration in BALF, MDA content in lung tissues, and W/D lung weight ratio, and increasing the SOD activity (P<0.05或0.01).Conclusion: The combination of propofol and ulinastatin can obviously reduce the lung injury after intestinal I/R in rats, and the efficacy is better than that of either of them alone.