摘要
目的 探讨体外循环期间进行肺动脉灌注低温保护液对未成熟犬肺损伤的预防作用 .方法 杂种幼犬 ( <30 d)12只 ,随机分为对照组 ( n=6 )和灌注组 ( n=6 ) .建立体外循环后 ,灌注组在心脏停跳的同时 ,肺动脉灌注 10℃低钾葡聚糖( L PD)保护液 ,阻断 90 min,复跳再灌注 6 0 min后 ,取肺组织观察肺表面活性剂 ( PS)、NO水平、肺湿干比 ( W/ D)、肺血管通透性 ( EB值 )和丙二醛 ( MDA)含量及肺组织结构变化 .对照组体外循环建立及阻断、再灌注时间同灌注组 .结果 灌注组 PS,NO水平较对照组显著提高 ( P<0 .0 5 ,P<0 .0 1) ,而灌注组肺组织 W/ D,EB值和 MDA含量较对照组明显降低( P<0 .0 1) .对照组肺间质水肿、肺泡内渗出、出血严重 ,超微结构肺泡 型上皮细胞微绒毛断裂消失 ,板层体减少、排空 ,内皮细胞肿胀 .灌注组结构变化明显减轻 .结论 肺动脉灌注低温 L PD肺保护液 ,可明显减轻体外循环对未成熟肺泡上皮细胞和肺血管内皮细胞的损伤 ,有效维持肺表面活性物质水平 ,减少肺血管外水含量 。
AIM To study the protection of pulmonary perfusion on immature lung injury by hypothermic lowpotassium dextran solution during CPB. METHODS Twelve immature dogs (<30 days) were devided into control group (n=6) and perfusion group (n=6) at random. At the time of ascend aortic artery clamped, 10℃ LPD solution was perfused into pulmonary artery in perfusion group. After 90 min clamps and 60 min reperfusion, lung tissue was obtained to observe the changes of PS, NO, MDA, permeanible of pulmonary vascular and the structure. RESULTS In perfusion group, PS and NO contents were significantly increased compared with control group (P<0.05, P<0.01). MDA content, W/D and EB value were significantly lower after perfusion of LPD solution (P<0.01). Edma of lung tissue and hemorrage of alveolar worsened in control group. Ultrostructure changes showed that lamellasone body (SB) was emptied and endothelial cells swellowed. CONCLUSION Perfusing pulmonary artery by means of hypothermic lowpotassium dextran solution could prevent immature lung epithelial and endothelial cells from ischemiareperfusion injury, sustain PS and NO level and reduce lung edema.
出处
《第四军医大学学报》
2000年第5期608-610,共3页
Journal of the Fourth Military Medical University
关键词
体外循环
未成熟肺
肺动脉灌注
保护
钾葡聚糖
cardiopulmonary bypass
immature lung/injury
pulmonary artery perfusion/protection
