治疗性高碳酸血症对肺移植缺血再灌注损伤后T淋巴细胞的影响  

The effects of hypercapnia on cd4 ＋ T lymphocytes of rats in which ischemia-reperfusion injury occurred during lung transplantation

作　　者：高伟[1] 曾宪章[1] 张莉莉[1] 李文志[1] 崔晓光[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：《中华胸心血管外科杂志》2009年第2期128-131,共4页Chinese Journal of Thoracic and Cardiovascular Surgery

基　　金：本课题受国家自然基金科学部面上基金资助（30471655）

摘　　要：目的探讨治疗性高碳酸血症（TH）对肺移植缺血再灌注损伤后T淋巴细胞的影响。方法16只肺移植成功后的Wistar大鼠，体重300—400g。随机分为对照组（n=8）和治疔组（n=8）。两组基础状态给予50％N2＋50％O2通气，对照组再灌注后给予50％O2通气；治疗组再灌注后给予40％N2＋60％O2和一定浓度的CO2混合气体，维持动脉血二氧化碳分压在80～100mmHg（1mmHg=0．133kPa），吸入氧浓度为50％。每组再灌注后观察90min，记录基础和再灌注后平均动脉压（MAP）和动脉氧分压（PaO2）。然后取外周血测量CD3、CD4、CD28阳性率；测量组织匀浆中IFN-γ、IL-2、IL-4和IL-10的浓度，并取部分组织行组织学分析。结果再灌注后，MAP和PaO2治疗组高于对照组（P〈0．05）。外周血中的CD3、CD4和CD28的阳性率和IL-2、IFN-γ浓度对照组高于治疗组（P〈0．05），IL-4对照组低于治疗组（P〈0．05）。IL-10两组间差异无统计学意义。组织切片显示，与对照组比较，治疗组出血、水肿明显减轻。结论TH对肺移植缺血再灌注损伤后T淋巴细胞具有抑制作用，可以减少外周血T淋巴细胞数量、抑制CD28的表达，减少Th1细胞分泌IL-2、IFN-γ，促进Th2分泌IL-4。Objective T lymphoeytes were considered to be activated and involved in the ischemia-reperfusion injury during lung transplantation. Carbon dioxide pncumoperitoneum was shown to have inhibitory activity on the immune system, This study was desired to investigate the effects of the therapeutic hypercapnia on the T lymphacytes of rats in which ischemia- reperfusion injury occurred during lung transplantation. Methods Sixteen Wistar rats weighed 300 to 400 g were randomized into control group （8 rats） or therapeutic group （8 rats） after transplantation. Animals in both groups were given inhaled nitrogen （50%） and oxygen N2 ＋ （50%） at baseline. Animals in the control group were given inhaled nitrogen （50%） and oxygen （50%） throughout the experiment, and that in the therapeutic group were given mixed gas which was composed of nitrogen （40%） , oxygen（60% ） and carbon dioxide in appropriate concontration to keep arterial partial pressure of earbon dioxide （PaCO2） at 80 - 100 rmn Hg and FiO2 at 50% after reperfusion. All of the animals were observed for 90 minutes after reperfusion. Mean arterial pressure （MAP） and arterial partial pressure of oxygen （PaO2） were recorded at baseline and every 15 minutes during the period of reperfusion. The expression of CD3, CD4 and CD28 in the peripheral blood was,examined, and the conceatrations of IFN-γ, IL-2, IL-4 and IL-10 in the homogenate were measured after the experiment. Histological analysis of samples from transplanted lungs was performed, Results After reperfusion, MAP and PaO2 in the therapeutic group were higher significantly than that in the control group（ P 〈 0.05）. The expression of CD3, CD4 and CD28 in the peripheral blood, and the conoertrations of IL-2 and IFN-γ in the homogenate were higher significantly in the control gronp than that in the therapeutic group （for all comperisons , P 〈0.05 ）. IL-4 was decreased in the control group as compared with the therapeutic group（P 〈 0.05）. No signfieant dif

关 键 词：肺移植再灌注损伤 高碳酸血 T淋巴细胞 

分 类 号：R686[医药卫生—骨科学]