治疗性高碳酸血症对巨噬细胞诱发大鼠移植肺急性排斥反应的影响  

Effects of therapeutic hypercapnia on acute pulmonary allograft rejection induced by macrophages in rats

作　　者：赵灿[1] 刘冬冬[1] 崔晓光[1] 

机构地区：[1]150086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

出　　处：《中华麻醉学杂志》2013年第9期1085-1088,共4页Chinese Journal of Anesthesiology

摘　　要：目的 探讨治疗性高碳酸血症对巨噬细胞诱发大鼠移植肺急性排斥反应的影响.方法 雄性成年Wistar大鼠24只,雄性成年SD大鼠12只,体重250 ～ 280 g,采用随机数字表法,将受体大鼠分为3组（n=6）：同种移植组（S组）、异种移植组（A组）和治疗性高碳酸血症组（H组）.S组以Wistar大鼠为供体和受体；A组和H组以SD大鼠为供体,以Wistar大鼠为受体,采用套袖法建立左肺原位移植模型.S组和A组再灌注期间吸入50％ N2-50％O2混合气体90 min；H组再灌注期间吸入N2-O2-CO2混合气体90 min,调节3种气体吸入浓度,维持PaCO2 80～ 100 mm Hg,吸入氧浓度48％～50％.术后7d时,采集动脉血样,行血气分析,计算氧合指数；采用酶联免疫吸附法检测血清TNF-α和IFN-γ的浓度.然后处死大鼠,取移植肺组织,HE染色,光镜下观察,行排斥反应评分；采用免疫组化法检测巨噬细胞浸润程度；采用原位末端标记法检测细胞凋亡,计算细胞凋亡指数.结果 与S组比较,A组PaCO2、血清TNF-α和IFN-γ的浓度、排斥反应评分和细胞凋亡指数升高,氧合指数降低,巨噬细胞增多（P＜0.05）；与A组比较,H组pH值和氧合指数升高,血清TNF-α和IFN-γ的浓度、排斥反应评分和细胞凋亡指数降低,巨噬细胞减少（P＜0.05）.结论 治疗性高碳酸血症可减轻巨噬细胞诱发大鼠移植肺急性排斥反应,可能与抑制炎性反应和细胞凋亡有关.Objective To investigate the effects of therapeutic hypercapnia on acute pulmonary allograft rejection induced by macrophages in rats.Methods Twenty-four adult male Wistar rats and 12 adult male Sprague-Dawley rats,weighing 250-280 g,were used in this study.The recipient rats were randomly divided into 3 groups using a random number table （n =6 each）：syngraft group （group S）,allograft group （group A） and therapeutic hypercapnia group （group H）.In group S,Wistar rats served as donors and recipients,while in A and H groups,Sprague-Dawley rats served as donors and Wistar rats served as recipients.Orthotopic left lung transplantation was performed using the cuff technique.After transplantation,the rats inhaled 50% N2-50% O2 for 90 min during reperfusion in S and A groups,while in group H the rats inhaled N2-O2-CO2 for 90 min during reperfusion and PaCO2 was maintained at 80-100 mm Hg and O2 concentration in inspired air at 48%-50% by adjusting the concentrations of the three gases.At 7 days after operation,the arterial blood sample was collected for blood gas analysis and for determination of serum concentrations of tumor necrosis factor α （TNF-α） and interferon γ （IFN-γ）by ELISA.The oxygenation index was calculated.Then the rats were sacrificed,and the transplanted lungs were removed for microscopic examination and for detection of infiltration of macrophages （by immunohistochemistry）and cell apoptosis （by using TUNEL） in lung tissues.The rejection was scored and apoptotic index was calculated.Results Compared with group S,PaCO2,serum concentrations of TNF-α and IFN-γ,rejection score,the number of macrophages and apoptotic index were significantly increased,and oxygenation index was decreased in group A （P 〈 0.05）.Compared with group A,pH value and oxygenation index were significantly increased,and serum concentrations of TNF-α and IFN-γ,rejection score,the number of macrophages and apoptotic index were decreased in group H （P 〈 0.05）.Conclusion Therapeutic hyper

关 键 词：高碳酸血 巨噬细胞 肺移植 移植物排斥 

分 类 号：R589[医药卫生—内分泌]