体外循环期间含三甲氧苄嗪低温保护液肺灌注对肺保护作用  

Lung protection of pulmonary artery perfusion with hypothermic trimetazidine fluid during cardiopulmonary bypass

作　　者：战鹏[1] 朱晓峰[1] 史宏宇[1] 周刚[1] 邹志田[1] 

机构地区：[1]佳木斯大学附属第一医院胸心外科,黑龙江佳木斯154003

出　　处：《黑龙江医药科学》2009年第4期44-45,共2页Heilongjiang Medicine and Pharmacy

摘　　要：目的:观察体外循环期间低温保护液肺动脉灌注对肺脏的保护作用以及添加细胞保护因子三甲氧苄嗪后对保护液作用的影响。方法:18只杂种犬随机分为对照组、试验组和TMZ组,每组6只。主动脉阻断后,对照组经右肺动脉灌注4℃乳酸林格液,实验组经右肺动脉分别灌注4℃肺保护液,TMZ组经右肺动脉分别灌注4℃含三甲氧苄嗪肺保护液。体外循环结束后90min,取左右肺下叶背段组织做丙二醛(MDA)、髓过氧化物酶(MPO)、一氧化氮(NO)、含水量及组织病理学检查。结果:CPB后对照组肺组织M DA含量和MPO活性明显升高,加入肺保护剂的实验组明显下降,而TMZ组在CPB后虽有增高,但明显低于对照组和实验组,同时肺组织中的NO含量明显高于其它两组,肺组织含水量明显低于其他两组(P<0.05)。光镜及透射电镜下观察肺泡及肺泡型上皮细胞,实验组、TMZ组右肺组织结构变化不明显。结论:CPB期间肺动脉灌注低温肺保护液可明显减轻CPB造成的肺组织损伤,而含三甲氧苄嗪的肺保护液具有更明显的优势。Objective：To explore lung protective effect of pulmonary artery perfusion with hypothermic protective solution and protective solution included trimetazidine during cardiopulmonary bypass（CPB）. Methods： 18 adult mongrel dogs were randomly divided into three groups, the control group,the study group and TMZ group. During CPB,the right pulmonary artery was perfused with 4 C Ringer lactate solution in control group, with 4C protective solution in study group and with 4 C protective solution including trimetazidine in TMZ group. After 90 minutes of CPB,the lung biopsies were obtained from right lungs at the low-back lung sect. The content of myeloperoxidase （MPO）, malondialdehyde （MDA） and NO were determined, the water content of the lung was determined, and the observation on the lung microstructure was also performed. Results：After CPB, the MPO and MDA were significantly increased in TMZ group than in other groups,NO was higher in TMZ group than in other groups and the water contents of lung in TMZ group significantly lower than other groups （P 〈 0.05）. Histologic and electron microscope examination revealed that alveolar type Ⅱ cells had approximate normal pulmonary parenchyma in study group and TMZ group. Conclusion：Pulmonary artery perfusion with hypothermic protective solution can obviously reduce lung injury after CPB, and the protective solution with trimetazidine is more optimal.

关 键 词：体外循环 三甲氧苄嗪 肺灌注 肺保护 

分 类 号：R654.1[医药卫生—外科学]