腺苷减轻体外循环后肺损伤的实验研究  

ADENOSINE ATTENUATES PULMONARY INJURY AFTER CARDIOPULMONARY BYPASS——AN EXPERIMENTAL STUDY

作　　者：钱伟民[1] 朱洪生[1] 卢蓉[1] 

机构地区：[1]上海第二医科大学附属仁济医院胸心外科

出　　处：《徐州医学院学报》1997年第6期32-35,共4页Acta Academiae Medicinae Xuzhou

摘　　要：目的研究腺苷能否减轻体外循环（ＣＰＢ）后肺组织损伤。方法采用杂种犬建立体外循环模型，腺苷（５０μｇ·ｋｇ－１·ｍｉｎ－１）中心静脉注入进行干预。结果腺苷组体外循环后血氧分压（ＰａＯ２）明显高于对照组（ＣＰＢ后３０ｍｉｎ，对照组为８．８０±１．０３ｋＰａ，腺苷组则为４０．１５±１．４８ｋＰａ，Ｐ＜０．０１），肺循环阻力指数（ＰＶＲＩ）降低（ＣＰＢ后３０ｍｉｎ，对照组为８４８．９８±３１．０５ｄｙｎｅ·ｓ－１·ｃｍ－５·ｋｇ－１，腺苷组为３１３．８４±１３７．０７ｄｙｎｅ·ｓ－１·ｃｍ－５·ｋｇ－１，Ｐ＜０．０１），而腺苷对体循环血流动力学则无显著影响。病检示肺泡结构正常，无明显白细胞浸润。肺组织过氧化脂质———丙二醛含量明显低于对照组，肺组织含水量较少。结论腺苷能减轻体外循环对肺组织的损害，在一定剂量范围内并不对体循环血流动力学构成显著影响，其作用机制可能与其减少体外循环后氧自由基的产生有关。Objective To study the effect of adenosine on pulmonary injury after cardiopulmonary bypass (CPB).Methods A mongrel dog model of CPB was established and adenosine was infused (50μg·kg·min-1).Results It was found that arterial oxygen tension (PO2) was higher (8.80±1.03kPa versus 40.15±1.48kPa, P<0.01) and pulmonary vascular resistance index (PVRI) was lower in adenosine group (310.84±137.07dyne·s-1·cm-5·kg-1) than in control group (848.98±310.05dyne·s-1·cm-5·kg-1, P<0.01). No adverse systemic hemodynamic effects of adenosine were observed. Histological evaluation of adenosine group revealed normal pulomnary architecture without conspicuous neutrophil infiltration. The content of lipid peroxide (MDA) in the pulmonary tissue and the amount of lung water were lower in the adenosine group.Conclusions Adenosine can attenuate the lung injury and right heart dysfunction caused by CPB. Given in proper dosage, it will cause no significant side effects on systemic hemodynamics. The protective effect of adenosine may be due to decreased production of oxygen free radicals.

关 键 词：体外循环 肺损伤 腺苷 

分 类 号：R654.1[医药卫生—外科学]