氧合血体外持续灌注保存对猪供肺移植后功能的影响  

Effect of ex vivo oxygenated blood continuous perfusion on pulmonary function in pigs after lung transplantation

作　　者：黄爱兰[1] 韦慧君 龙小毛[1] 胡彦艳[1] 江晓欢[3] 

机构地区：[1]广西壮族自治区人民医院,南宁530021 [2]广西医科大学第二附属医院 [3]玉林市第一人民医院

出　　处：《山东医药》2017年第22期5-8,共4页Shandong Medical Journal

基　　金：国家自然科学基金资助项目(81360020)

摘　　要：目的观察氧合血体外持续灌注保存对猪供肺移植后功能的影响。方法将24只广西巴马小型香猪随机分为观察组与对照组各12只,每组供体、受体各6只。手术切除观察组与对照组供体双侧肺,分别经氧合血体外持续灌注保存、低温静态保存各8 h,后将供体左肺分别移植入两组切除左肺的受体。比较两组再灌注0.5、2、4、6 h时左下肺静脉氧合指数(PaO_2/FiO_2),HE染色观察两组供肺保存前(T_0)、供肺保存8 h(T_1)、再灌注3 h(T_2)和再灌注6 h(T_3)左下肺肺组织病理。结果观察组再灌注0.5、2、4、6 h时左下肺静脉PaO_2/FiO_2分别为(482.50±30.72)、(467.17±31.06)、(441.17±17.86)、(422.33±46.45)mm Hg,对照组分别为(413.83±18.53)、(389.67±7.28)、(313.67±24.53)、(308.50±50.45)mm Hg,观察组再灌注6 h与本组再灌注0.5 h时相比,对照组再灌注4、6 h与本组再灌注0.5 h时相比,两组再灌注各时点相比,P均﹤0.05。两组随再灌注时间延长,肺间质逐渐增宽,肺泡组织结构逐渐塌陷,肺泡水肿逐渐明显,肺泡腔内可见渗出物,且对照组肺组织结构损伤在同一时间点比观察组重,T3时对照组肺组织水肿分级比观察组高(P﹤0.05)。结论氧合血体外持续灌注保存猪供肺移植后肺氧合功能稳定、组织结构较完整。Objective To observe the effect of ex vivo oxygenated blood continuous perfusion on lung function in pigs after lung transplantation. Methods Twenty-four Guangxi miniature pigs were randomly divided into the observation group and the control group,and each group had 6 donors and 6 receptors. After being completely resected,bilateral lungs of the donors were preserved by ex vivo oxygenated blood continuous perfusion and static cold storage for eight hours,respectively,and then the left lungs were transplanted into the receptors. We compared the PaO2/FiO2 of the left lower pulmonary vein between the observation group and the control group at 0. 5,2,4,6 h after reperfusion. Using HE staining to observe the pulmonary tissues,which were collected at the time of before preserving（ T0）,after eight hours saved（ T1）,three（ T2） and six（ T3） hours after reperfusion. Results The PaO2/FiO2 of the left lower pulmonary vein were（ 482. 50 ±30. 72）,（ 467. 17 ± 31. 06）,（ 441. 17 ± 17. 86）,and（ 422. 33 ± 46. 45） mm Hg in the observation group,versus（ 413. 83 ± 18. 53）,（ 389. 67 ± 7. 28）,（ 313. 67 ± 24. 53）,and（ 308. 50 ± 50. 45） mm Hg in the control group,at 0. 5,2,4,6 h after reperfusion,respectively. There were significant differences between 6 h and 0. 5 h in observation group,between 4 h,6 h and 0. 5 h in the control group as well as between these two groups at each time point（ all P〈0. 05）.Pathological examination showed that,as the time went by,alveolar interval became wider gradually,alveolar structure gradually collapsed,alveolar edema got obvious,and exudation was seen in the alveolar cavity. The organization structure of pulmonary tissue in the control group changed worse than that in the observation group,and the pulmonary edema grading of the control group was higher than that of the observation group at T3（ P〈0. 05）. Conclusion The donor lungs after being protected with ex vivo oxygenated blood continuous perfusion can obtain a better oxygenation and m

关 键 词：肺移植 供体保存 氧合血 体外持续灌注保存 低温静态保存 缺血再灌注损伤 肺功能 动物实验 

分 类 号：R617[医药卫生—外科学]