肺缺血预处理对体外循环诱发犬肺缺血再灌注时水通道蛋白1表达的影响  

Effect of lung ischemic preconditioning on expression of aquaporin-1 during lung ischemia-reperfusion induced by cardiopulmonary bypass in dogs

作　　者：罗俊丽[1,2] 王勇[1,2] 李姗姗[1,2] 窦雪娇[1,2] 韩明[1,2] 张红[1,2] 

机构地区：[1]贵州省麻醉与器官保护基础研究重点实验室,563003 [2]遵义医学院附属医院麻醉科,563003

出　　处：《中华麻醉学杂志》2014年第6期683-686,共4页Chinese Journal of Anesthesiology

基　　金：贵州省科学技术基金

摘　　要：目的探讨肺缺血预处理对体外循环（CPB）诱发犬肺缺血再灌注时水通道蛋白1（AQPl）表达的影响。方法健康成年杂种犬12只，体重15～20k，雌雄不拘，采用随机数字表法分为2组（n=6）：肺缺血再灌注组（I／R组）和缺血预处理组（IP组）。非停跳CPBl0min时阻断左肺动脉，停止左肺机械通气，60min后开放左肺动脉，恢复左肺机械通气，建立CPB诱发肺缺血再灌注损伤模型。IP组在阻断左肺动脉前进行缺血预处理：阻断5min，开放5min，2个循环。于CPB前（T1）、阻断左肺动脉即刻（T2）、停CPB时（T3）、停CPB后2h（T4）时取肺组织，测定肺组织湿干重（W／D）比值，观察病理学结果，进行肺损伤评分，采用Westernblot法检测AQPl表达；于．T1、T3、T4时点计算呼吸指数（RI）、氧合指数（0I）和肺泡-动脉血氧分压差P（A-a）O2；T4时点计算左肺肺泡液体清除率。结果与I／R组比较，IP组L、T4时P（A-a）q和RI降低，0I升高，肺组织W／D比值和肺损伤评分降低，肺组织AQPl表达上调，左肺肺泡液体清除率升高（P〈0．05）。IP组肺组织病理学损伤较I／R组减轻。结论肺缺血预处理减轻CPB诱发犬肺缺血再灌注损伤的机制与上调肺组织AQPI表达有关。Objective To investigate the effect of lung ischemic preconditioning （IP） on the expression of aquaporin-1 （AQP1） during lung ischemia-reperfusion （I/R） induced by cardiopulmonary bypass i CPB） in dogs. Methods Twelve adult mongrel dogs, weighing 15-20 kg, were randomly divided into 2 groups （ n = 6 each） ： lung I/R （group I/R） and ischemic preconditioning group （group IP）. The left pulmonary artery was occluded at 10 min of off-pump CPB and mechanical ventilation was stopped in the left lung, 60 min later occlusion was released, and mechanical ventilation was recovered to establish the model of left lung ischemia-reperfusion injury induced by CPB. In group IP, lung ischemic preconditioning was induced by 2 cycles of 5 min ischemia followed by 5 min reperfusion before occlusion of the left pulmonary artery. Before CPB （Tl ）, immediately after occlusion of the left pulmonary artery （ T2 ）, at the end of CPB （ T3 ）, and at 2 h after the end of CPB （ T4 ）, pulmonary specimens were collected for determination of wet to dry lung weight ratio （W/D ratio） and expression of AQP1 and for examination of the pathological changes of lungs which were scored. Respiration index （ RI）, oxygenation index （OI）, and alveolar-arterial oxygen tension difference （P（A-a）02 ） were calculated at Tl , T3 and T4, and the left pulmonary alveolar fluid clearance （AFC） was calculated at T4 ·Results Compared with group I/R, P（A-a） 02 and RI were significantly decreased, OI was increased, W/D ratio and pathological scores were decreased, the expression of AQP1 was up-regulated, and the AFC was increased at T3 and T4 in group IP. The pathological changes of the lung were significantly attenuated in group IP as compared with group I/R. Conclusion The mechanism by which lung ischemic preconditioning mitigates lung I/R injury induced by CPB is related to up- regulation of the expression of AQP1 in dog lung tissues.

关 键 词：缺血预处理 心肺转流术 再灌注损伤 肺 水通道蛋白质1 

分 类 号：R614[医药卫生—麻醉学]