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调查。我们研究了各种麻醉剂对血管内皮细胞和中性粒细胞功能的影响，它们在缺血-再灌注器官损伤中起核心作用。首先，建立兔双侧后肢及腹部脏器缺血再灌注模型。然后我们观察了内皮细胞和中性粒细胞的活化以及缺血再灌注引起的器官损伤。我们还研究了麻醉管理是否会影响这些变化。结果表明，麻醉药物对缺血再灌注过程中中性粒细胞活化和器官损伤有显著影响。更具体地说，七氟醚和异丙酚减弱了缺血再灌注诱导的中性粒细胞活化。这些麻醉剂还能防止缺血再灌注引起的器官损伤。我们还发现，在同一模型中，神经轴阻断抑制了中性粒细胞的活化。我们打算研究对中性粒细胞活化的药理学干预。目的观察体外循环和食管切除术围手术期血管内皮细胞和中性粒细胞的功能变化。体外循环过程中，交叉钳松开后中性粒细胞明显活化。结果还表明，中性粒细胞活化程度与术后肺功能障碍相关。在食管切除术病例中，中性粒细胞激活发生在手术开始24小时后。进一步探讨肝、肠缺血再灌注损伤的机制。

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.