Effect of penehyclidine hydrochloride on non-ventilated lung injury and endoplasmic reticulum stress in patients with radical resection of pulmonary cancer

Liu Xiaole; Zhou Junhui; Fang Fang; Meng Rui; Xi Gaoyuan; Meng Xianhui

doi:10.3760/cma.j.issn.1673-4777.2017.11.011

Abstract：Objective To explore the effect of penehyclidine hydrochloride on non-ventilated lung injury and endoplasmic reticulum stress(ERS) in patients with radical resection of pulmonary cancer.Methods Eighty patients undergoing radical surgery of pulmonary cancer from January to August 2016 in Henan Chest hospital were randomly divided into penehyclidine hydrochloride preconditioning group(group P) and control group (group C),with 40 cases in each group.The group C had intravenous injection of 0.9％ sodium chloride solution and the group P had intravenous injection of 0.01 mg/kg penehyclidine hydrochloride 10 min before anesthesia induction.Arterial partial pressure of oxygen(PaO2) and arterial partial pressure of carbon dioxide(PaCO2) were monitored before drug treatment(T0),at the time of one lung ventilation(T1),60 min after one lung ventilation (T2),at the end of one lung ventilation(T3),at the end of operation(T4) and 24 h after operation(T5).The wet to dry weight ratio of left lung lower lobe,score of lung injury,pathological and ultrastructural changes of left lung lower lobe,expressions of glucose regulated protein 78 (GRP78) and nucleotide sequence(CCAAT)/enhancer-binding protein homologous protein (CHOP) were recorded at T1 and T3.Serum levels of tumor necrosis factor-α (TNF-α),interleukin-6(IL-6) and IL-8 were detected.Results PaO2 at T1-T4 were significantly higher than that at T0 in both groups (P ＜ 0.05).PaO2 at T2-T4 in group P were significantly higher than those in group C (P ＜ 0.05).The wet to dry weight ratio of left lung lower lobe and score of lung injury at T3 were significantly higher than those at T1 in both groups [group C:(6.76 ± 0.27) vs (4.02 ± 0.15),(2.2 ± 0.8) points vs (0.0 ± 0.0) points;group P:(5.33 ± 0.20) vs (3.98 ± 0.16),(0.9 ± 0.7) points vs (0.0 ± 0.0) points] (P ＜ 0.05).The wet to dry weight ratio of left lung lower lobe and score of lung injury at T3 in group P were significantly lower than those in group C (P ＜ 0.05).Pathological and ultrastructural changes of left lung lower lobe in group P were more significant than those in group C.Expressions of GRP78 and CHOP mRNA and protein at T3 were significantly higher than those at T1 in group P and group C(P ＜0.05).Expressions of GRP78 and CHOP mRNA and protein at T3 in group P were significantly lower than those in group C(P ＜0.05).Levels of TNF-α,IL-6 and IL-8 at T2-T5 were higher than those at T0 in both groups and there were significant differences between groups (P ＜ 0.05).Conclusion Penehyclidine hydrochloride preconditioning can reduce damage on non-ventilated lung in patients undergoing radical surgery of lung cancer,the mechanism may be associated with its alleviation on ERS.