Effects of anesthetic drugs on ischemia-reperfusion induced organ damage

在本研究项目中，研究者进行了实验室和临床研究。本研究探讨了不同麻醉剂对缺血再灌注损伤中起核心作用的血管内皮细胞和中性粒细胞功能的影响。1.实验室研究首先建立了家兔双侧后肢和腹部器官缺血再灌注模型。然后，我们研究了内皮细胞和中性粒细胞活化和器官损伤引起的缺血再灌注。我们还研究了麻醉管理是否影响这些变化。结果表明，麻醉剂对缺血再灌注时中性粒细胞的活化和器官损伤有明显影响。更具体地说，七氟烷和丙泊酚减弱了缺血再灌注诱导的中性粒细胞活化。这些麻醉剂还可以预防缺血再灌注引起的器官损伤。我们还发现，在同一模型中，轴突阻滞抑制中性粒细胞活化。本研究旨在探讨药物对中性粒细胞活化的干预作用。2.临床研究本研究观察了体外循环和食管癌切除术围手术期血管内皮细胞和中性粒细胞的功能变化。在体外循环期间，中性粒细胞在交叉夹释放后显著活化。中性粒细胞活化程度与术后肺功能障碍有关。在食管切除术病例中，中性粒细胞活化发生在手术开始后24小时。本实验旨在进一步研究肝、肠缺血再灌注损伤。

In this research project, the investigators underwent both laboratory and clinical investigation. We investigated the effects of various anesthetic agents on the function of vascular endothelial cells and neutrophils which plays a central role in ischemia-reperfusion organ injury.1.Laboratory Investigation First, we established ischemia-reperfusion model of bilateral hind limb and abdominal organs in rabbits. Then we investigated endothelial and neutrophil activation and organ damage induced by ischemia-reperfusion. We also studied whether anesthetic management influence these changes. The results indicates that anesthetic agent significantly influenced the neutrophil activaition and organ injury during ischemia-reperfusion. More specifically, sevoflurane and propofol attenuated eggegerated neutrophil activation induced by ischemia-reperfusion. These anesthetic agents also prevented ischemia-reperfusion induced organ damage. We also found neuraxial blockage suppressed neutrophil activation in the same model. We intend to investigate pharmacological intervention to the neutrophil activaition.2.Clinical Investigation We investigated the functional change of vascular endothelial cells and neutrophils during cardiopulmonary bypass and perioperative period of esophageal resection. During cardiopulmonary bypass, neutrophils were significantly activated after the cross clamp release. The results also indicates the degree of neutrophil activation correlated postoperative pulmonary dysfucntion. In esophagectomy cases, neutrophil activation occured 24 hours after sugery started. We aim further investigation on ischemia-reperfusion injury of liver and intestine.