评价含抑肽酶肺保护液疗效的实验研究  

Effect of aprotinin added to preservation solution for lung

作　　者：付庆林[1] 孟慧[2] 吕丽红[3] 陈忠堂[2] 邵军[3] 尹金岭[3] 

机构地区：[1]新乡医学院第一附属医院心外科,河南新乡453100 [2]济南市中心医院心外科,山东济南250013 [3]山东大学医学院手术学研究室,山东济南250012

出　　处：《山东大学学报（医学版）》2005年第12期1151-1154,共4页Journal of Shandong University:Health Sciences

摘　　要：目的:利用兔在体肺保存模型,评价含抑肽酶的改良肺保护液对肺的保护作用。方法:新西兰白兔30只,随机分为对照组、低钾右旋糖酐液(LPD液)组、抑肽酶组,每组10只。制备兔在体左肺保存模型,对照组仅阻断肺门和冷藏,不灌肺保护液,LPD液组和抑肽酶组分别经肺动脉插管,在体灌注LPD液和含抑肽酶的LPD液,完毕后将左肺下叶放入特制的肺保存器内在体低温冷藏2h,移去肺保存器,开放肺门再灌注2h。在实验过程中抽取肺静脉血标本行血气分析,取肺组织行病理学检查,同时检测支气管灌洗液中性粒细胞百分比及肺湿/干重比以评价肺保存效果。结果:抑肽酶组再灌注5min和2h两个时间点肺静脉血氧分压显著高于LPD液组和对照组(P<0.05)。抑肽酶组肺泡出血及肺结构损害分级均较对照组及LPD组轻微(P<0.05)。肺湿/干重比抑肽酶组较对照组和LPD液组均有非常显著的差异(P<0.01)。结论:含抑肽酶的肺保护液对肺的保护效果确切,其保护作用明显优于单纯LPD液。Objective： To explore the protective effect of aprotinin contained LPD （low potassium dextran） solution with rabbit in situ lung preservation models. Methods： Thirty New Zealand rabbits were randomly divided into 3 groups, 10 in each group. In group A （control group）, the left lung hilus was clamped without pulmonary artery perfusion. In group B （LPD group） and group C （LPD ＋aprotinin group）, the pulmonary artery was perfused with LPD solution and aprotinin contained LPD solution, respectively. The lungs in all groups were stored at 10℃ in a specially made lung preservation container for 2 hours and then unclamped the lung hilus to re-perfuse the lung for 2 hours. Pulmonary venous blood samples were collected at pre-clamping of lung hilus, 5 minutes and 2 hours after reperfusion for analysis of blood gas. Biopsy of lung tissue was excised for morphological examination reperfusion. Examination of bronchoalveolar lavage fluid at pre-declamping of lung hilus and 2 hours after was taken for the evaluation of inflammation status.Lung wet/dry weight ratio was detected. Result： PvPO2 （partial pressure of oxygen in pulmonary venous blood） in group C at 5 minutes and 2 hours after reperfusion were significantly higher than those in group A and group B. The morphological lesion was more severe in group A and B than that in group C. The PMN percentage in bronchoalveolar lavage fluid in group A and B was significantly higher than that in group C. Left lung wet/dry weight ratio in group C was significantly lower than that in group A and B. Conclusion： The protective effect of aprotinin is apparent for lung protection in animal model. Aprotinin contained lung preservation solution is superior to LPD for lung protection.

关 键 词：抑肽酶 生物学 肺移植 保护液 

分 类 号：R655.3[医药卫生—外科学]