关键词: 七氟醚；血红素氧化酶(脱环)；肺功能；肺外科手术；氧化性应激

Abstract:

Objective   To observe the effects of sevoflurane preconditioning on the expression of heme oxygenase-1(HO-1) in the operated lung tissue, and on the lung protection of patients who underwent pulmonary lobectomy.  Methods   30 patients, ASAⅠ or Ⅱ,  aged 40 to 60 years, weighting 50 to 75kg, scheduled for pulmonary lobectomy, were randomly divided into two groups with 15 cases in each group, including propofol all by intravenous anesthesia group (group P) and sevoflurane preconditioning group (group S). In group S， before one-lung ventilation, the patients inhaled 1% to 2% sevoflurane for 30mins, as a simulation of sevoflurane preconditioning.While in group P, patients were supplied propofol all by intravenous anesthesia in the same period. 4mL elbow venous blood samples were collected at the beginning of the anesthesia induction (T0), immediately before one-lung ventilation (T1), immediately at the end of one-lung ventilation (T2), 30mins after one-lung ventilation (T3), respectively, in order to determine the level of serum malondialdehyde (MDA). The content of heme oxygenase-1 in the normal lung tissue of removal pulmonary lobe was detected. 1mL radial artery blood samples were collected for measuring  the oxygenation index (PaO2/FiO2) at 2h after surgery.  Results   The content of HO-1 of removal lung tissue was significantly higher in group S than in Group P(P<0.05). At the time point of T3, the level of serum MDA was significantly lower in group S than in groupP(P<0.05). At 2h after surgery, the oxygenation index (PaO2/FiO2) was significantly higher in group S than in group P(P<0.05). Conclusion   Sevoflurane preconditioning can play a role in lung protection by up-regulating the expression of HO-1 in lung tissue, and reducing the oxidative stress injury induced by one-lung ventilation.