治疗性高碳酸血症对肺移植缺血-再灌注损伤早期炎症因子的影响  

Effect of therapeutic hypercapnia on the early inflammatory factors after ischemia-reperfusion injury of lung transplantation

作　　者：王玲[1] 拉佈旦白拉[1] 

机构地区：[1]内蒙古医科大学附属医院麻醉科,呼和浩特010050

出　　处：《器官移植》2014年第1期8-11,共4页Organ Transplantation

摘　　要：目的 研究治疗性高碳酸血症对肺移植缺血-再灌注早期炎症因子的影响.方法 72只Wistar雄性大鼠,随机分为模型组（36只）和治疗组（36只）.两组基础状态给予50% N2 ＋ 50% O2通气,模型组移植成功后给予50% N2 ＋ 50% O2通气;治疗组移植成功后给予50% O2、8%CO2和42% N2通气,维持动脉血二氧化碳分压（PaCO2）在80~100 mmHg（10 mmHg=1.33 kPa）之间.记录受体大鼠机械通气1 min时MAP、PaCO2和动脉血氧分压（PaO2）作为基础值,再灌注期间每30 min记录1次,直至实验结束.分别于再灌注1、2、4 h取左肺下叶组织,采用酶联免疫吸附法测定肺组织中肿瘤坏死因子（TNF）-α和白细胞介素（IL）-1β的水平.结果 与模型组比较,再灌注后各时间点治疗组受体鼠的MAP、PaO2均明显升高（均为P〈0.05）.与模型组比较,治疗组各时间点移植肺组织中TNF-α和IL-1β水平均有显著下降（均为P〈0.05）.结论 治疗性高碳酸血症对肺移植缺血-再灌注损伤后早期炎症因子的释放有抑制作用.Objective To investigate the effect of therapeutic hypercapnia on the early inflammatory factors after ischemia-reperfusion of lung transplantation. Methods Seventy-two male Wistar rats were randomly divided into model group （ n = 36 ） and therapy group （ n = 36 ）. Rats on the baseline in model group and therapy group were ventilated with 50% N2 and 50% 02. Rats in model group were continuously ventilated with 50% N2 and 50% 02 after successful transplantation. Rats in therapy group were ventilated with mixed gases after successful transplantation, which included 50% 02, 8% CO2, and 42% N2 to keep arterial partial pressure of carbon dioxide （PaCO2） in the range of 80 - 100 mmHg （10 mmHg = 1.33 kPa）. The mean arterial pressure （MAP） , PaCO2 and arterial partial pressure of oxygen （ PaO2 ） of recipient rats were recorded as baseline value after mechanical ventilation for 1 minute. Then the data were recorded once every 30 minutes during reperfusion period until the end. The inferior lobes of left lung sample were taken at 1, 2, 4 h after repeffusion respectively. The levels of tumor necrosis factor （ TNF ） -α and interleukin （ IL ） -1β in lung tissues were measured by enzyme-linked immunosorbent assay. Results Compared with model group, MAP and PaO2 were significantly higher in therapy group at different time points after reperfusion （ all in P 〈 0. 05 ）. Compared with model group, the levels of TNF-α and IL-1β of transplant lung tissues were significantly lower in therapy group at different time points after reperfusion （ all in P 〈 0. 05 ）. Conclusions The therapeutic hypercapnia plays an inhibitive role on the release of early inflammatory factors after the isehemia-reperfusion injury of lung transplantation.

关 键 词：治疗性高碳酸血症 肺移植 缺血-再灌注损伤 炎症因子 

分 类 号：R617[医药卫生—外科学]