犬急性肺缺血再灌注损伤的病理学改变及中药814的干预作用  

Effects of Chinese herbs 814 on the pathomorphologic changes of acute ischemia/reperfusion lung injury

作　　者：顾晴[1] 何建国[1] 程显声[1] 阮英茆[2] 吴振军[1] 朱明娟[3] 

机构地区：[1]中国医学科学院中国协和医科大学心血管病研究所阜外心血管病医院心血管内科,北京100037 [2]阜外心血管病医院病理科 [3]中国医学科学院中国协和医科大学血液学研究所,天津300020

出　　处：《临床心血管病杂志》2004年第12期733-735,共3页Journal of Clinical Cardiology

基　　金："九五"国家医学科技攻关项目 (No :96 92 0 2 0 0 2 )

摘　　要：目的 :探讨肺缺血再灌注损伤的病理学改变及中药 814的干预作用。方法 :7只杂种犬随机分两组 :①急性肺缺血再灌注组 (3只 ) :结扎左主肺动脉 2 4h后恢复血流 4h ;②中药 814干预组 (4只 ) :再灌注前予中药 814腹腔注射 ,应用光镜和电镜等病理检测方法观察缺血期、再灌注期、中药 814干预后肺组织病理形态学改变 ,计算受损肺泡百分率。结果 :①急性肺缺血再灌注组 :缺血期 ,左肺散在出血 ,部分肺泡上皮细胞及肺血管内皮细胞胞质肿胀、线粒体空泡化、内质网扩张 ;同例对照右肺基本正常。再灌注期 ,左肺出血加重 ,肺间质及广泛肺泡腔内有水肿液 ,受损肺泡百分率显著增加 ,肺泡上皮细胞和肺血管内皮细胞肿胀、线粒体空泡化及嵴溶解加重 ,可见细胞坏死 ;同例对照右肺大致正常或散在小灶性肺泡腔内有水肿和出血 ,少数肺泡上皮细胞和肺血管内皮细胞轻度线粒体肿胀和空泡化。②中药 814干预组 :再灌注期左肺受损肺泡百分率显著减少 ,少数肺泡上皮细胞和肺血管内皮细胞线粒体轻度肿胀和空泡化。结论 :急性缺血后再灌注肺组织病理学形态显示比较明显的损伤 ,中药Objective:To explore the pathomorphologic changes of Lung injury during ischemia/reperfusion(IR) and to observe effect of Chinese herbs 814 on IR lung injury. Method:①Acute IR group, the left main pulmonary artery was ligated for 24 hours and followed by 4 hours of reperfusion. ②Intervention group, Chinese herbs 814(3 ml/kg) were injected before reperfusion. Lung pathomorphologic changes were observed and the percentage of damage alveoli was measured during IR in two groups. Result:①In acute IR group after pulmonary artery occlusion, the left lung showed patchy hemorrhage, blood vessels congestion. Cytoplasmic swelling, mitochondria vacuolization and dilation of the endoplasmic reticulum were appeared in some alveolar epithelial cells and vascular endothelial cells. The right lung as control was normal. After reperfusion, the left lung became diffusely hemorrhagic and produced interstitial or alveolar edema. White blood cells aggregated in pulmonary blood vessels. Necrosis, more serious mitochondria vacuolization and ridge dissolution were appeared in some alveolar epithelial cells and vascular endothelial cells. The percontage of elamage alveoli in the left lung after reperfusion was significanthy high than after ischemia (P< 0.05).②In intervention group, the left lung showed mild mitochondria vacuolization in a few alveolar epithelial cells and vascular endothelial cells. The percentage of damage alveoli was significantly lower than acute IR group(P< 0.05). Conclusion: There is minimal lung injury during ischemia, but remarkable lung injury is found during reperfusion. Chinese herbs 814 can prevent and treat ischemia/reperfusion lung injury.

关 键 词：再灌注损伤 肺 病理学 中药 

分 类 号：R563.5[医药卫生—呼吸系统]