不同血液pH值对大鼠肺移植时缺血再灌注损伤的影响  

Effects of different blood pH of the recipients on ischemia-reperfusion injury to the transplanted lungs in rats

作　　者：段若望[1] 李明星[1] 宋炯[1] 

机构地区：[1]同济大学附属上海市肺科医院麻醉科,200433

出　　处：《中华麻醉学杂志》2010年第6期685-687,共3页Chinese Journal of Anesthesiology

摘　　要：目的 评价不同血液pH值对大鼠肺移植时缺血再灌注损伤的影响.方法 纯种雄性SD大鼠64只（供体和受体鼠各32只）,体重250～350 g,行同种异体左单肺移植术,32只受体鼠随机分为4组（n=8）,移植肺再灌注前经股静脉注射1 mol/L HCl溶液和7.5%NaHCO3溶液,调整其血液pH值,Ⅰ组、Ⅱ组、Ⅲ组和Ⅳ组pH值分别调整为7.4、7.2、7.3和7.5.移植肺再灌注2 h时取肺组织,测定肺湿/干重比（W/D）、髓过氧化物酶（MPO）和SOD活性、MDA、TNF-α和IL-8的含量,光镜下观察肺组织病理学结果.结果 与Ⅰ组比较,Ⅲ组移植肺组织SOD活性明显升高（P＜0.01）,MPO活性、MDA、TNF-α及IL-8含量均降低（P＜0.05）,W/D差异无统计学意义（P＞0.05）,与其它3组比较,Ⅲ组肺组织病理损伤减轻;Ⅰ组、Ⅱ组和Ⅳ组各指标比较差异无统计学意义（P＞0.05）.结论 降低血液pH值到7.3可减轻大鼠肺移植时缺血再灌注损伤.Objective To investigate the effects of different blood pH of the recipients on ischemiareperfusion （I/R） injury to the transplanted lungs in rats. Methods Sixty-four pure bred male SD rats weighing 250-350 g were randomly divided into equal numbers of donors and recipients and the recipient rats were randomly divided into 4 groups（n = 8 each）. Both donor and recipient rats were anesthetized with intraperitoneal （IP）ketamine 15 mg/kg and diazepam 6 mg/kg, tracheostomized and mechanically ventilated. In donor rats heparin 1 ml was injected via inferior vena cava and 4 ℃ LDP solution 40 ml was injected via pulmonary artery . The left lung was then removed and placed in 4℃ LDP solution and kept for 4 h. The left lung transplantation was performed using two-cuff-one-stent anastomosis technique. Before the transplanted lung was reperfused, the recipients＇ blood pH was adjusted to 7.4 （group Ⅰ）, 7.2 （group Ⅱ）, 7.3 （group Ⅲ） and 7.5 （group Ⅳ） by HCI and NaHCO3 solutions infused via femoral vein. After 2 h reperfusion, the transplants were removed for microscopic examination and determination of W/D lung weight ratio, MPO and SOD activities and MDA, TNF-α and IL-8 contents. Results SOD activity was significantly higher while MPO activity, and MDA, TNF-α and IL-8 contents in the lung tissue were significantly lower in group Ⅲ than in group Ⅰ . There was no significant difference in SOD and MPO activities and MDA, TNF-α, and IL-8 contents in the lung tissue among group Ⅰ , Ⅱ and Ⅳ. There was no significant difference in W/D lung weight ratio among the 4 groups. Microscopic examination showed that the histological damage was attenuated in group Ⅲ compared with the other 3 groups. Conclusion The I/R injury to the transplanted rat lungs can be effectively alleviated by reducing blood pH of the recipients to 7.3.

关 键 词：氢离子浓度 肺移植 再灌注损伤 

分 类 号：R655.3[医药卫生—外科学]