异丙酚-氯胺酮麻醉对兔严重烧伤早期细胞因子平衡的影响

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Abstract [Abstract]Objective To investigate the influence of Propofol-Ketamine anesthesia on cytokine balance in early stage of severe burn in rabbits.Methods Thirty male New Zealand rabbits were selected and they were randomly divided into normal control group(group C,n=10),burn control group(group BC,n=10)and Propofol-Ketamine anesthesia group(group PK,n=10).The internal jugular vein and external carotid artery were placed in the tube after anesthesia with Sodium Pentobarbital a day before burn.On the day of the experiment,the rabbits in group BC and group PK were made into 30%body surface area (TBSA)3 degree burn models.In group PK,Propofol 1.5 mg/kg was injected intravenously 1 hours after injury,then endotracheal intubation 90 s later,next half closed oxygen supply with anesthesia machineopen,retaining spontaneous breathing,Propofol of 0.15 mg/(kg·min)and Ketamine of 0.15 mg/(kg·min)were infused intravenously to maintain anesthesia,and the drugs were discontinued after 4 hours of anesthesia.Group C was injected Sodium lactate Ringer solution,and the input volume was 80 ml/(d·kg).Group BC and PK were injected crystal colloid(1∶1),and the volume of fluid infusion was 1.75×(%TBSA)×weight+80 ml/(d·kg).Before burn and 1,6,12 and 24 hours after burn,arterial blood was collected for blood gas analysis,and serum levels of interleukin-1 (IL-1),interleukin-6(IL-6)and tumor necrosis factor-α (TNF-α)concentration were measured by venous blood sampling.Results There was no significant difference in the volume of transfusion between group BC and PK(P＞0.05).Compared with group C,the volume of transfusion in group BC and PK increased significantly,and the differences were statistically significant(P＜0.05).PaCO2in group BC and PK after burn was significantly lower than that in group C(P＜0.05).Lac in group BC and PK after burn was significantly higher than that before burn (P＜0.05),and group PK was significantly lower than that group BC (P＜0.05).There was no significant difference in pH,PaO2and SaO2at any time points compared with that before burn (P＞0.05).IL-1,IL-6 and TNF-α in group BC and PK after burn were significantly higher than those before burn (P＜0.05).Group PK anaesthetized by Propofol-Ketamine,the concentration of IL-1,IL-6 and TNF-α in group PK were lower than those in group BC at 6,12 and 24 h after burn (P＜0.05).Conclusion Propofol-Ketamine anesthesia can effectively reduce the level of serum cytokines,inhibit systemic inflammatory response in the early stage of severe burn,at the same time,it can improve tissue perfusion,which is conducive to early recovery of severe burn.

Key words： Propofol Ketamine Severe burn Cytokine

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[1]	夏建国，项尽一，原晓晖，等.不同剂量氯胺酮对兔严重烧伤早期全身炎症反应的影响[J].中国中西医结合急救医学杂志，2015，22（4）：286-289.
[2]	夏建国，孙建斌，祁荣，等.氯胺酮-异丙酚或芬太尼-异丙酚麻醉下严重烧伤早期患者切痂植皮术后炎性反应的比较[J].中华麻醉学杂志，2008，28（9）：853-854.
[3]	项尽一，夏建国，张昆，等.不同麻醉药物对兔严重烫伤早期炎性反应的影响[J].重庆医学，2016，45（24）：3330-3333.
[4]	刘利兵，于军，张子策，等.新西兰兔烧伤模型建立[J].第四军医大学学报，2009，30（1）：86-88.
[5]	王子恩，陈昭宏，陈晓东，等.不同剂量多巴胺对严重烫伤大鼠早期血流动力学及心肌力学的影响[J].中华烧伤杂志，2017，33（2）：115-118.
[6]	廖明锋，陈堃，张志发，等.氯胺酮对大鼠神经元缺氧时线粒体功能的影响[J].中华麻醉学杂，2016，36（11）：1400-1402.
[7]	李毅，徐东波，王洪瑾.硫化氢对深Ⅱ度烧伤大鼠创面巨噬细胞分泌细胞因子的影响[J].中华烧伤杂志，2016，32（7）：408-412.
[8]	陈卓，夏建国，王晖，等.丙泊酚对兔严重烧伤早期并发肾组织损伤时肿瘤坏死因子α水平的影响[J].广东医学，2015，36（21）：3322-3324.
[9]	计鹏，胡大海，杨晨，等.重度烧伤并发脓毒症64例血清TNF-α、IL-1β、IL-6水平测定及其相关性分析[J].陕西医学杂志，2016，45（9）：1173-1174.
[10]	Shi CS，Shenderov K，Huang NN，et al.Activation of autophagy by inflammatory signals limits IL-1β production by targeting ubiquitinated inflammasomes for destruction[J].Nat Immunol，2012，13（3）：255-263.
[11]	张巧云，李思颉，牛敬忠，等.低氧预适应对急性脑梗死小鼠血清TNF-α、IL-1β和IL-6炎性反应因子的影响[J].首都医科大学学报，2016，37（1）：89-92.
[12]	李俊杰，蒋海燕，邵建林.脑缺血-再灌注损伤大鼠脑组织中TNF-α，IL-6和IL-1β的表达[J].昆明医科大学学报，2016，37（9）：31-35.
[13]	韩露，陈子，柏芳芳，等.芹菜素逆转白介素6诱导的中性粒细胞凋亡延迟[J].南京医科大学学报（自然科学版），2017，37（4）：399-402.
[14]	Starnes HF，Pearce MK，Tewari A，et al.Anti-IL-6 monoclonal antibodies protect against lethal Escherichia coli infection and lethal tumor necrosis factor-alpha challenge in mice[J].J Immunol，1992，148（6）：1968.
[15]	Kawasaki C，Kawasaki T，Ogata M，et al.Ketamine isomers suppress superantigen-induced proinflammatory cytokine production in human whole blood[J].Can J Anaesth，2001，48（8）：819-823.
[16]	夏建国，项尽一，王晖，等.异丙酚对严重烫伤兔的肝保护效应[J].中华麻醉学杂志，2015，35（7）：834-836.
[17]	杨雪，孙赳，曾思，等.TLR4/NF-κB信号通路与丙泊酚抑制内毒素诱导大鼠肺泡巨噬细胞TNF-α释放的关系[J].中华麻醉学杂志，2017，37（6）：761-764.
[18]	Jia J，Sun Y，Hu Z.Propofol inhibits the release of interleukin-6，8 and tumor necrosis factor-α correlating with high-mobility group box 1 expression in lipopolysaccharidesstimulated RAW 264.7 cells[J].BMC Anesthesiol，2017，17（1）：148.