移植肺过度膨胀对肺循环血液动力学的影响  

Influence of graft hyperinflation on hemodynamics of pulmonary circulation

作　　者：洪文娟 杨林珠[1] 洪志鹏[1] 张璟[1] 尹小川[1] 太祥[1] 黄韬[1] 余庆鹤[1] 

机构地区：[1]昆明医科大学第一附属医院胸外科,云南昆明650031

出　　处：《中华肺部疾病杂志（电子版）》2012年第5期4-7,共4页Chinese Journal of Lung Diseases(Electronic Edition)

基　　金：国家自然科学基金(81060010);云南省教育厅科学基金(04z869c;05kjt16)

摘　　要：目的探讨供肺过度膨胀对肺循环血液动力学所产生的作用及机制。方法建立肺的过膨胀动物模型。对照组和实验组(各8只杂种犬)均保持肺过度膨胀6h,实验组经股静脉给予血管扩张剂前列腺素(PGE-1)。监测肺循环动脉压,取标本检测肺组织湿/干比和支气管肺泡灌洗液蛋白含量。结果术后两组肺动脉压均升高,对照组明显高于实验组(P<0.05),两组体循环动脉压及中心静脉压无明显差异(P>0.05);对照组的肺组织湿/干比明显高于实验组(P<0.05);支气管肺泡灌洗液中蛋白含量检测对照组明显高于实验组,分别为2.12±0.82g/L和1.32±0.55g/L,P<0.05。结论肺过度膨胀导致肺循环动脉压升高,不利于对供肺的保护,其作用机制与外在力学因素造成肺容积过度扩大、肺循环障碍有关。Objective To assess the impact of donor hyperinflation on hemodynamics of lung circulation, and explore its possible mechanism. Methods Sixteen mongrels were randomly divided into two groups, control group and experimental group. Animal model of lung hyperinflation canine was established. The control group was kept lung hyperinflation for 6 hours, on the basis of the former, the experimental group was given vasodilator prostaglandinE-1 （PGE-1）, continuous intravenous injection（30 ng·kg-1·min-1 ）. Pulmonary artery pressure, mean artery pressure and central venous pressure were monitored continuously for 6 hours; the changes of lung tissue wet weight/dry weight ratio and total protein content of bronchoalveolar lavage fluid were measured after 6 hours. Results After operation, pulmonary artery pressure increased, significantly higher in the control group than in the experimental group （ P 〈 0.05 ）, there was no significantly different in mean artery pressure and central venous pressure between the two groups （ P 〉 0.05 ） ; wet weight/ dry weight ratio, total protein content of bronchoalveolar lavage fluid （2.12±0.82 g/L and 1.32±0. 55 g/L） were significantly higher in the control group than in the experimental group （P 〈 0. 05 ）. Conclusion The pulmonary artery pressure is raised by the hyperinflation of the lung. The mechanism may be connected with total lung volume excessive enlargement and the detriment of pulmonary circulation.

关 键 词：肺循环 过膨胀 肺损伤 肺移植 

分 类 号：R655.3[医药卫生—外科学]