快速再灌注和逐步再灌注对肺再灌注损伤的影响  

The effect of instant reperfusion and gradual reperfusion on lung reperfusion injury

作　　者：王卓[1] 王辰[2] 

机构地区：[1]北京大学第四临床医学院-北京积水潭医院呼吸科,100035 [2]首都医科大学附属北京朝阳医院北京呼吸疾病研究所

出　　处：《北京医学》2006年第7期388-392,共5页Beijing Medical Journal

摘　　要：目的建立肺栓塞相关肺缺血-再灌注损伤动物模型,比较快速和逐步再灌注对肺再灌注损伤的影响。方法应用Swan-Ganz漂浮导管球囊建立犬肺缺血-再灌注损伤动物模型。将犬随机分为三组,每组5只,均观察28h。假手术组放入Swan-Ganz漂浮导管但不阻塞血管。快速再灌注组(以下简称快速组)球囊阻塞左下肺动脉24h后迅速抽空球囊。逐步再灌注组(以下简称逐步组)在再灌注时将球囊于30min内逐步抽空,余同快速组。观察血流动力学、血气、肺组织湿重/干重比及肺组织病理变化。结果大体标本观察:假手术组未见损伤,快速组损伤面积大于逐步组。左下叶肺组织湿重/干重比:快速组(7.87±0.95)明显高于逐步组(6.06±0.74)和假手术组(5.33±1.15),P均<0.05;逐步组与假手术组之间无显著性差异,P>0.05。快速组的多个肺叶所含红细胞、白细胞、水肿液的肺泡数明显多于逐步组,P<0.05。左下叶肺泡间隔厚度:快速组〔(9.0±0.7)〕μm明显>逐步组〔(7.2±1.2)〕μm,P<0.05;此两组均明显大于假手术组(5.8±0.7),P<0.05。结论应用改良的球囊阻塞法建立的肺缺血-再灌注损伤动物模型是成功的。逐步再灌注可以减轻肺栓塞相关肺再灌注损伤。Objectives This experiment is aimed to study the influence of instant and gradual reperfusion on lung reperfusion injury in the modified balloon occlusion model using Swan-Ganz catheter. Methods 15 male or female mongrels were divided into three groups randomly. The experiment lasted 28 hours in every group. Group A （sham operation group, n=5） underwent the Swan-Ganz catheterization but without pulmonary artery occlusion. Group B （gradual reperfusion group, n=5） underwent occlusion of left lower pulmonary artery by the Swan-Ganz catheter balloon for 24 hours, followed by gradual reperfusion with an initial reperfusion at low flow rate for 30 minutes, then by a rate of normal flow for 3.5 hours. Group C （instant reperfusion group, n=5） underwent instant and complete reperfusion. The other operations were as the same as those of group B. The hemodynamic parameters, arterial blood gas, wet-to-dry lung weight ratio and pathology were measured in 3 groups. Results The autopsies showed that normal lung appearance in group A, small area of hemorrhage in group B and large area of hemorrhage in group C. The wet-to-dry lung weight ratio in the left lower lobe of group C （7.87±0.95）was greater than that of group B （6.06±0.74） and group A （5.33± 1.15 ） significantly, （P〈0.05）; there was no significant difference between group A and group B （P〉0.05）. The number of alveolus with ery- throcyte, leucocyte, and exudation in several lobes of group C was more than group B significantly （P〈0.05）. The thickness of alveolar septum in left lower lobe of group C [（9.0±0.7）]μm was significantly thicker than Group B [（7.2±1.2） μm] and Group A[（5.8±0.7）μm]（P〈0.05）. That of Group B was significantly thicker than Group A （P〈0.05）. Conclusions The animal model with lung ischemia-reperfusion injury was established successfully using Swan-Ganz catheter balloon occlusion method. It is showed by angiography that occlusion and reperfusion is definite and complete. The metho

关 键 词：肺缺血-再灌注损伤 动物模型 肺栓塞 逐步再灌注 

分 类 号：R655.3[医药卫生—外科学]