改良白细胞滤器对体外循环模型犬肺保护的实验研究  

The Pulmonary Protective Effects of Leukocyte Depletion with a Modified Filter Located at the Cardiopulmonary Bypass (CPB) Venous Line in Canine

作　　者：李崎[1] 陈卉娇[2] 杜磊[1] 周棱[1] 王莹[1] 刘斌[1] 

机构地区：[1]四川大学华西医院麻醉科,成都610041 [2]四川大学华西医院病理科

出　　处：《四川大学学报（医学版）》2005年第5期723-726,共4页Journal of Sichuan University(Medical Sciences)

基　　金：国家自然科学基金(批准号30400439)资助

摘　　要：目的观察犬体外循环(CPB)管路静脉端使用改良白细胞滤器(LD-1)进行短时间白细胞滤过对犬肺的保护作用。方法16只健康杂种犬建立CPB模型后,随机分为LD-1组和对照组。LD-1组在CPB管路的静脉端安装LD-1,CPB初期开放白细胞滤器5min。对照组无LD-1。于CPB前、CPB5、10、40、70min、主动脉开放5min、停机、鱼精蛋白中和后5min、停CPB2h9个时点测血常规。于CPB前、鱼精蛋白中和后5min、停CPB2h检测氧合指数、肺组织的病理变化和血浆中IL-6、IL-8的水平。于停CPB2h检测肺泡灌洗液(BALF)中IL-6、IL-8的水平。结果LD-1组白细胞计数在CPB5min明显低于对照组,差异有统计学意义(P<0.05),但从CPB40min至停CPB2h各时点两组间差异均无统计学意义(P>0.05)。鱼精蛋白中和后5min、停CPB2h氧和指数LD-1组明显高于对照组,差异有统计学意义(P<0.05);LD-1组肺组织白细胞浸润和肺泡壁水肿明显轻于对照组。鱼精蛋白中和后5min两组血浆IL-6和IL-8的水平差异无统计学意义(P>0.05);停CPB2hLD-1组明显低于对照组,差异有统计学意义(P<0.05)。停CPB2h两组BALF中IL-6水平差异无统计学意义(P>0.05);而LD-1组IL-8水平低于对照组(P<0.05)。结论在犬CPB管路静脉端使用改良LD-1进行短时间白细胞滤过,能明显减少循环中白细胞的数目,减少血浆中IL-6、IL-8的水平,减轻CPB后肺部的炎性反应,对犬肺有保护作用。Objective To investigate the pulmonary protective effects of short-term leukocyte depletion with a modified filter located at the CPB venous line in canine. Methods Sixteen healthy hybrid canines were randomly allocated to the LD-1 group, with an LD-1 filter installed in the CPB venous-line for a 5-minute leukocyte depletion at the beginning of the CPB, and to the control group. Blood samples were taken for routine test respectively at 9 time-points, namely pre-CPB, at 5, 10, 40, 70 min of the CPB, 5 min after aortic cross-clamp being off, at the discontinuation of the CPB, 5 min after protamine being administered, and 2 h after the CPB. Oxygen index （OI）, pulmonary pathology and levels of interleukin-6 （IL-6） and interleukin-8 （IL-8） in plasma were measured at pre-CPB, 5 min after protamine being administered and 2 h after the CPB respectively. The levels of IL-6 and IL-8 in the bronchial alveolar lavage fluid （BALF） were measured at 2 h after the CPB. Results In LD-1 group, white blood cell （WBC） counts were significantly less than those in control group at 5 min of the CPB （P〈0. 05）, the filtration rate of WBC was （65. 72±9.36）%. The WBC counts showed no significant difference in either group from 40 min of the CPB to 2 h after the CPB. OI was higher in LD-1 group than that in control group （P〈0. 05） at 5 min after protamine being administered and 2 h after the CPB. There was significantly less WBC infiltration and alveolar edema of the lung in LD-1 group than that in control group at 5 min after protamine being administered and 2 h after the CPB. There were no significant differences of IL-6 and IL-8 in plasma between the two groups at 5 min after protamine being administered （P〉0. 05）, but the levels of IL-6 and IL-8 were much lower in the LD-1 group than those in the control group at 2 h after CPB. At 2 h after the CPB, IL-6 level in the BALF showed no significant difference in each group （P〉0. 05）; however, the level of IL-8 was lower in LD-1 group than that

关 键 词：白细胞滤过 体外循环 肺保护 

分 类 号：R-332[医药卫生]