冷缺血期间经一氧化碳膨肺减轻大鼠移植肺缺血再灌注损伤  

Lung inflation with carbon monoxide during the cold ischemia phase ameliorates lung ischemia-reperfusion injury

作　　者：康继宇 孟超[2] 刘洋[1] 张广超[1] 杨雪[1] 周华成[1] 

机构地区：[1]哈尔滨医科大学附属第四医院麻醉科,150001 [2]哈尔滨医科大学附属第二医院麻醉科

出　　处：《中华器官移植杂志》2016年第3期170-175,共6页Chinese Journal of Organ Transplantation

基　　金：中国博士后科学基金（201104453）;国家自然科学基金（81570088）

摘　　要：目的观察冷缺血期经一氧化碳（CO）膨肺对大鼠肺移植后肺缺血再灌注损伤（IRI）的作用以及作用机理。方法取SD大鼠24对建立大鼠肺移植模型，采用随机数字表法将24只受鼠分为3组，每组8只。（1）一氧化碳膨肺组（CO组）：在供肺冷缺血期，采用体积分数为百万分之500的CO＋体积分数40％O2＋N2膨肺，气体体积为5ml／kg；（2）氧气膨肺组（02组）：在供肺冷缺血期，采用体积分数40％O2＋体积分数60％N2膨肺；（3）对照组：不使用气体进行膨肺处理。O2组和CO组每30min置换气体1次，180min冷缺血期完毕后行肺移植。分别于移植前，再灌注即刻，以及再灌注后60、120和180min采集各组受鼠的血液样本进行血液气体分析；再灌注180min时，检测各组受鼠血清中相关炎症因子及移植肺组织细胞凋亡和NF-κB蛋白的表达情况。结果再灌注180min时，O2组受鼠氧合指数为（293±78）mmHg，CO组为（361±48）mmHg，均较对照组的（238±61）mmHg明显升高（P〈0．05）；与O2组相比，CO组氧合指数显著增加（P〈O．05）。同样，与对照组相比，O2组和CO组血清IL-8、TNF-α及凋亡细胞明显降低，与O2组相比，CO组IL-8、TNF-α及凋亡细胞显著降低，NF-κB蛋白表达明显降低（P〈0．05）。结论冷缺血期应用CO膨肺通过抑制NF-κB介导的炎症反应和细胞凋亡从而减轻了大鼠肺缺血再灌注损伤。Objective To observe the monoxide （CO） during the cold ischemia phase effects and mechanism of lung inflation with carbon on lung ischemia-reperfusion injury （IRI） after rat lung transplantation.Method Twenty-four pairs of SD rats were selected to establish the model of lung transplantation, and random number method was used to divide 24 donors into 3 groups with 8 rats in each group. （1） CO inflation group （CO group）： During the cold ischemia phase, 500 ppm CO ＋ volume fraction 40% O2 ＋ N2 was used for lung inflation, and the volume was 5 mL/kg; （2） 02 inflation group （O2 group）： During the cold ischemia phase, volume fraction 40% O2 ＋ volume fraction 60% N2 was used for lung inflation （3） Control group： The lung was deflated during the cold ischemia phase. The gas was replaced every 30 min in the CO and O2 groups, and the lung transplantations were performed after 180 rain of cold ischemia. The arterial blood gas analysis was performed at baseline, 3 min after reperfusion, and 60, 120, and 180 min after reperfusion The recipient serum levels of relative inflammatory factors, lung tissue cell apoptosis and nuclear factor kappa B （NF-κB） protein expression were detected after 180 min of reperfusiom Result As compared with the control group （238± 61 mm Hg）, the oxygenation index in the 02 group （293 ± 78 mm Hg） and CO group （361 ± 48 mm Hg） was increased （P〈0. 05）, and as compared with the 02 group, that in the CO group was increased （P〈0. 05）. Furthermore, as compared with the control group, the interleukin （IL）-8, tumor necrosis factor （TNF）-α, and cell apoptosis in the 02 group and CO group were decreased significantly, and as compared with the O2 group, those in the CO group and NF-κB protein expression were significantly decreased （P〈0. 05）. Conclusion Lung inflation with CO duringthe cold ischemia phase ameliorated the rat lung IRI via reducing the inflammatory response and cell apoptosis mediated by the NF-κB pathway.

关 键 词：大鼠 肺移植 一氧化碳 冷缺血期 再灌注损伤 核因子κB 

分 类 号：R614[医药卫生—麻醉学]