Detecting alveolar epithelial injury following volatile anesthetics by 99mTc DTPA radioaerosol inhalation lung scan
Detecting alveolar epithelial injury following volatile anesthetics by 99mTc DTPA radioaerosol inhalation lung scan
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DOI：
10.1159/000029449
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发表时间：
1999-11-01
期刊：
影响因子：
3.7
通讯作者：
Liao, KK
中科院分区：
文献类型：
--
作者：
ChangLai, SP;Hung, WT;Liao, KK
背景：许多挥发性麻醉剂长期以来被认为影响肺泡上皮的通透性。目的：本研究的目的是研究挥发性麻醉剂对Tc-99m DTPA肺泡毛细血管屏障通透性的急性影响。方法：选取27例手术患者，其中女24例，男3例，年龄29 ~ 73岁，按麻醉方式分组。第一组患者给予1%氟烷。第二组患者给予1.5%异氟醚。第三组患者采用静脉麻醉，不使用挥发性麻醉药。麻醉前后行Tc-99m DTPA放射性气溶胶吸入肺部扫描，检测挥发性麻醉药引起的肺泡上皮损伤。回归线的负斜率指定为Tc-99m DTPA肺清除率，并以每分钟放射性下降百分比表示。结果：1组麻醉前后Tc-99m DTPA清除率分别为1.26 +/- 0.34和1.29 +/- 0.38。差异无统计学意义（p < 0.05）。2组麻醉前后的发生率分别为0.76 +/- 0.20和1.10 +/- 0.37。差异有统计学意义（p < 0.05）。第三组麻醉前后清除率分别为1.07 +/- 0.38和1.21 +/- 0.48。差异不显著。结论：异氟醚给药后，Tc-99m DTPA的肺清除率更快，表明异氟醚增加了肺泡-毛细血管屏障的通透性。版权所有(C) 1999 S. Karger AG，巴塞尔。
Background: Many volatile anesthetics have long been thought to affect alveolar epithelial permeability. Objective: The purpose of this study was to examine the acute effects of volatile anesthetics on the permeability of the alveolocapillary barrier to Tc-99m DTPA. Methods: Twenty-seven patients (24 females, 3 males, age 29-73 years) undergoing operation were enrolled in this study and grouped according to the type of anesthesia received. Group 1 patients were administered 1% halothane. Group 2 patients were given 1.5% isoflurane. Intravenous anesthesia without volatile anesthetics were used for group 3 patients. Before and after anesthesia, Tc-99m DTPA radioaerosol inhalation lung scans were performed to detect alveolar epithelial injury due to volatile anesthetics. The negative slope of the regression line was designated as the Tc-99m DTPA pulmonary clearance rate and was expressed in terms of percentage decrease in radioactivity per minute. Results: In group 1, the Tc-99m DTPA clearance rates were 1.26 +/- 0.34 and 1.29 +/- 0.38 before and after anesthesia, respectively. The difference was not significant (p > 0.05). In group 2, the rates were 0.76 +/- 0.20 and 1.10 +/- 0.37, before and after anesthesia, respectively. The difference was significant (p < 0.05). In group 3, the clearance rates were 1.07 +/- 0.38 and 1.21 +/- 0.48, before and after anesthesia, respectively. The difference was not significant. Conclusions: Following isoflurane administration, the more rapid pulmonary clearance of Tc-99m DTPA indicates that isoflurane increases the permeability of the alveolo-capillary barrier. Copyright (C) 1999 S. Karger AG, Basel.