治疗性高碳酸血症对大鼠移植肺肺泡Ⅱ型上皮细胞的影响  

Effect of therapeutic hypercapnia on type Ⅱ alveolar cells in transplanted lung in rats

作　　者：申东方[1] 王玲[1] 谭晶[1] 高伟[1] 曾宪章[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 黑龙江省麻醉与危重病学研究重点实验室,150086

出　　处：《中华麻醉学杂志》2011年第4期475-477,共3页Chinese Journal of Anesthesiology

基　　金：国家自然科学基金（30471655）

摘　　要：目的探讨治疗性高碳酸血症对大鼠移植肺肺泡Ⅱ型上皮细胞（ATⅡ）的影响。方法肺移植成功后的成年雄性Wistar大鼠28只，周龄6周，体重180～220g，采用随机数字表法，将大鼠随机分为2组（n=14）：对照组（C组）和治疗性高碳酸血症组（T组）。再灌注期间C组吸入50％O2—50％N2；T组吸入O2、N2和CO2混合气体，调整混合气体的浓度，维持吸入氧浓度50％，动脉血二氧化碳分压80-100mmHg，再灌注90min时取移植肺肺静脉血样行血气分析，计算氧合指数；采用酶消化法分离、纯化ATⅡ，鉴定并观察超微结构；流式细胞术检测ATⅡ凋亡情况。结果与C组比较，T组氧合指数增高，ATⅡ凋亡率降低（P〈0．05）。T组ATⅡ超微结构损伤程度轻于C组。结论治疗性高碳酸血症可减少大鼠移植肺ATⅡ凋亡，从而改善肺功能。Objective To investigate the effects of therapeutic hypercapnia on type Ⅱ alveolar cells （ATH） in the transplanted lung in rats. Methods Twenty-eight pathogen free adult male Wistar rats weighing 180-220 g were randomly divided into 2 groups （ n = 14 each） ： control group （group C） and therapeutic hypercapnia group （group T）. The animals were anesthetized with intraperitoneal 3% pentobarbital 30 mg/kg, tracheostomized and mechanically ventilated with 50% O2-50% N2 （VT 10 ml/kg, RR 60 bpm, I： E 1 ： 1）. Left lung transplantation was performed. In group T starting from the beginning of reperfusion of the transplanted lung, the animals were ventilated with a mixture of 50% O2-N2 and CO2 （in appropriate concentrations） to keep PaCO2 between 80-100 mm Hg. After 90 min of reperfusion of the transplanted lung, blood samples were Collected from pulmonary vein of the transplanted lung and blood gas analysis was performed. Oxygenation index was calculated. AT Ⅱ ceils were isolated from the transplanted lung and purified and examined with electronic microscope. The apoptosis rate of AT Ⅱ cells was detected by flow cytometry. Results Oxygenation index was significantly higher, the apoptotic rate of ATⅡ cells lower, the damage to ATⅡ cells was less in group T than in group C.Conclusion Therapeutic hypercapnia can protect the AT Ⅱ cells in the transplanted lung and improve the function of the transplanted lung.

关 键 词：高碳酸血 肺移植 肺泡 上皮细胞 

分 类 号：R655.3[医药卫生—外科学]