Effect of penehyclidine hydrochloride pretreatment on non-ventilated lung injury in elderly patients with video-assisted-thoracoscopic pulmonary lobectomy
Chu Yang
Abstract：Objective To explore the effect of penehyclidine hydrochloride (PHC) pretreatment on the damages of non-ventilated lung of video-assisted-thoracoscopic pulmonary lobectomy in elderly patients.Methods Totally 120 elderly patients who had thoracoscopic pulmonary lobectomy from January 2015 to May 2016 in the Affiliated Hospital of Liaoning University of Traditional Chinese Medicine were randomly divided into observation group and control group,with 60 cases in each group.The observation group was intravenously injected PHC 0.05 mg/kg and the control was injected equal volume of 0.9％ sodium chloride solution 10 min before anesthesia induction.Venous blood was took for detection of tumor necrosis factor-α (TNF-α),interleukin-6 and -8 (IL-6,IL-8) before drug intervention (T0),immediately when one-lung ventilation started (T1),60 minafter one-lung ventilation(T2),immediately when one-lung ventilation was ended(T3),immediately when the operation was ended(T4) and at 24 h after operation(T5),respectively.Normal lung tissue surrounding resected lung lobe was excised at T1 andT3;the Index of Quantitative Evaluation for Alveolar Damage(IQA) and Apoptosis Index (AI) were calculated;CCAAT/enhancer-binding protein homologous protein (CHOP) mRNA and protein expression were detected.The incidence of postoperative pulmonary complications was recorded within 72 h after operation.Results Levels of TNF-α,IL-6 and IL-8 in observation group were significantly lower than those in control group from T2 to T5 (P ＜ 0.05).IQA,AI CHOP mRNA and protein expression in observation group were significantly lower than those in control group at T3 [(15.8 ± 3.8) ％ vs (23.7 ± 2.5) ％,(14.8 ± 2.7) ％ vs(25.8 ±3.7)％,(0.72±0.15) vs (0.89 ±0.22),(0.69±0.20) vs (0.97 ±0.29)](P＜0.05).Pulmonary complication incidences within 72 h after operation in observation group were significantly lower than those in control group[16.7％ (10/60) vs 46.7％ (28/60)] (P ＜0.05).Conclusion PCH can alleviate damages to non-ventilated lung in elderly patients with video-assisted-thoracoscopic lobectomy;the mechanism may be related to the effects on alleviating inflammation and inhibiting pneumonocyte apoptosis induced by CHOP.
Keywords：Pulmonary lobectomyPenehyclidine hydrochlorideOne-lung ventilationLung injuryCCAAT/enhancer-binding protein homologous proteinPneumonocyte apoptosis
Publication Date：2017-02-28
Online Publishing Date：2026-09-14(First online date of this platform, not the publication date of the document)
Pages：6( 210-215 )