腺苷对犬体外循环后肺缺血-再灌注损伤的作用  

The Effect of Adenosine on Ischemia-reperfusion Lung Injury of Mongrel Dog after Extracorporeal Circulation

作　　者：钱伟民[1] 朱洪生[2] 卢蓉[2] 

机构地区：[1]徐州医学院附属医院胸心外科,江苏徐州221002 [2]上海第二医科大学附属仁济医院胸心外科

出　　处：《中国胸心血管外科临床杂志》2001年第1期24-27,共4页Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

摘　　要：目的　研究腺苷是否能减轻体外循环后肺组织损伤。　方法　 12条犬随机分为实验组和对照组。建立体外循环模型 ,实验组使用腺苷 (5 0 μg/kg·min)中心静脉持续滴注 ;对照组滴注生理盐水。分别于各时间点测定血流动力学、右心功能和动脉血气分析 ;测定肺组织含水量、丙二醛含量 ,并进行病理分析。　结果　两组心率、体循环平均动脉压、左心房压、中心静脉压比较无差异 ,与对照组比较实验组体外循环后肺血管阻力降低 ,右心功能改善 ,动脉血氧分压明显升高 ;肺组织含水量较少 ,肺组织丙二醛含量较低 (P<0 .0 5或 P<0 .0 1)。病理检查 :实验组犬肺泡结构正常 ,无明显中性粒细胞浸润。　结论　腺苷能够减轻体外循环后肺缺血 -再灌注损伤 ,改善右心功能 ,在一定剂量范围内并不对体循环血流动力学构成明显影响。Objective\ To investigate the effect of adenosine on pulmonary injury after extracorporeal circulation.\ Methods\ Twelve mongrel dogs were randomly divided into two groups, the test group and control group. The model of extracorporeal circulation was established. In the test group and control group, adenosine(50μg/kg·min) and normal saline were infused before extracorporeal circulation respectively. Hemodynamics, right cardiac function and arterial blood gas were assessed. Lung water and malondialdehyde content were assessed. Histological evaluation was also made.\ Results There were no differences between the two groups with respect to heart rate, mean systemic artery pressure, left atrial pressure, and central venous pressure. In the test group, pulmonary vascular resistance was lower and right cardiac function improved remarkably; arterial oxygen pressure (PaO 2) was also higher, less lung water was observed and the malondialdehyde content in the pulmonary tissue was lower ( P<0.05,P<0.01). Histological evaluation of the test group revealed normal pulmonary architecture without abundant intra alveolar neutrophils.\ Conclusion\ Adenosine can attenuate ischemia reperfusion lung injury and right cardiac insufficiency caused by extracorporeal circulation. At a proper dose, there was no significant effect on systemic hemodynamics.

关 键 词：腺苷 体外循环 肺缺血-再灌注损伤 右心功能不全 

分 类 号：R654.1[医药卫生—外科学]