治疗性高碳酸血症对大鼠移植肺细胞凋亡的影响  

Effects of therapeutic hypercalmia on the apoptosis in transplanted lung in rats

作　　者：崔晓光[1] 郭悦平[1] 高伟[1] 张莉莉[1] 曾宪章[1] 陈晓杰[1] 李文志[1] 

机构地区：[1]哈尔滨医科大学附属第二医院麻醉科哈尔滨医科大学麻醉基础理论与应用研究实验室,150086

出　　处：《中华麻醉学杂志》2007年第10期918-920,共3页Chinese Journal of Anesthesiology

基　　金：国家自然基金科学部主任基金资助项目（30440004）

摘　　要：目的探讨治疗性高碳酸血症对移植肺细胞凋亡的影响及其可能的机制。方法26只Wistar大鼠,供体鼠和受体鼠各13只,肺移植成功后随机分为2组：对照组（n=6）和治疗组（n= 7）。对照组再灌注期间吸入50%N2-50%O2混合气体;治疗组再灌注期间吸入40%N2-60%O2- 100%CO2混合气体,调节吸入二氧化碳和氧气的流量,维持吸入氧浓度50%,动脉血二氧化碳分压（PaCO2）80～100 mm Hg。记录受体鼠机械通气15 min时平均动脉压（MAP）、PaCO2和动脉血氧分压（PaO2）作为基础值,再灌注期间每15分钟记录1次,直至实验结束。再灌注90 min时放血处死大鼠,采用考马斯亮蓝法测定支气管肺泡灌洗液（BALF）蛋白浓度;取左肺组织,计算湿/干重比;采用免疫组化法测定Bax、Bcl-2的表达;采用TUNEL法检测细胞凋亡情况。结果与基础值比较,再灌注期间对照组MAP和PaO2降低（P〈0.05）;与对照组比较,再灌注期间治疗组MAP、PaCO2和PaO2升高,BALF蛋白浓度、肺组织W/D、Bax表达和细胞凋亡指数降低（P〈0.05）,Bcl-2表达差异无统计学意义（P〉0.05）。结论治疗性高碳酸血症可抑制大鼠移植肺细胞凋亡,其机制与下调Bax蛋白表达有关。　Objective To investigate the effects of the therapeutic hypercapnia on apeptosis in the transplanted lung and the mechanism.Methods Twenty-six Wistar rats weighing 300-400 g of which 13 were donors and other 13 recipients.After successful lung transplantation the 13 recipients were randomized into 2 groups：Ⅰcontrol group（n=6）andⅡhypercapnia group（n=7）.The animals breathed 50% N2-50% O2 after reperfusion of the transplanted lung was started in control group,while in hypercapnia group the animals breathed 40% N2-60% O2-CO2 and PaCO2 was maintained at 80-100 mm Hg by adjusting the CO2 of the inspired air.The animals were mechanically ventilated for 90 min after reperfusion of the transplanted lung.MAP,PaO2 and PaCO2 were measured and recorded before transplantation（baseline）and at 15,30,45,60,75 and 90 min after beginning of reperfusion.The animals were killed by exsangnination.The transplanted lungs were immediately removed for determination of protein concentration of broncho-alveolar lavage fluid（BALF）,W/D lung weight ratio,Bax and Bcl-2 expression using immuno-histochemistry and apoptotic cells（TUNEL）.The apoptotic index （the number of apeptotic cells/total number of cells）was calculated.Results MAP and PaO2 were significantly decreased after reperfusion was started as compared with the baseline in control group and were significantly lower than in hypereapnia group.The protein concentration of BALF,W/D ratio and the number of Bax-positive cells and apoptotic index were significantly lower in hypereapnia group than in control group.Conclusion The therapeutic hypercapnia can inhibit the apoptosis in the transplanted lung by down-regulating the Bax protein expression in the transplanted lung in rats.

关 键 词：高碳酸血 肺移植 细胞凋亡 

分 类 号：R686[医药卫生—骨科学]