肺动脉前向血流对双向格林分流术中肺血管内皮功能的影响  

Effect of anterior pulmonary blood flow on pulmonary vascular endothelial function in bilateral Glenn surgery

作　　者：单雪峰[1] 马松峰[1] SHAN Xuefeng;MA Songfeng(Department of Pediatric Cardio-Thoracic Surgery,First Affiliated Hospital of Xinjiang Medical University,Urumqi 830011,China)

机构地区：[1]新疆医科大学第一附属医院小儿心胸外科,乌鲁木齐830011

出　　处：《山西医科大学学报》2021年第10期1369-1373,共5页Journal of Shanxi Medical University

基　　金：新疆维吾尔自治区自然科学基金项目(2017D01C345)。

摘　　要：目的探讨双向格林(Glenn)分流术中肺动脉前向血流(anterior pulmonary blood flow,APBF)对肺动脉血管内皮功能的保护性作用。方法建立幼兔双向Glenn分流术的动物模型,根据术中主肺动脉的保留程度分为3组(每组5只):完全保留APBF组(不结扎主肺动脉),部分保留APBF组(结扎主肺动脉至其直径的0.71),不保留APBF组(完全结扎主肺动脉);同时非手术幼兔作为空白对照组。建模成功后饲养幼兔3月以给予组织器官重构,饲养满3月后取各组幼兔肺组织行免疫组化检测肺动脉内膜中内皮型一氧化氮合酶(endothelial nitric oxide synthase,eNOS)和弹力蛋白的变化,Western blot检测肺组织中eNOS和内皮素-1(endothelin-1,ET-1)的表达变化。结果免疫组化结果显示:与完全保留APBF组及空白对照组比较,部分保留APBF组兔肺动脉血管内膜中eNOS表达降低(P<0.05),而不保留APBF组兔肺动脉血管内膜中eNOS表达较部分保留APBF组进一步下降(P<0.05);与空白组及完全保留APBF组弹力蛋白的表达比较,部分保留APBF组兔肺动脉血管中弹力蛋白的表达升高(P<0.05),而不保留APBF组兔肺动脉血管中弹力蛋白的表达较部分保留APBF组进一步升高(P<0.05)。Western blot结果显示:与完全保留APBF组及空白对照组比较,部分保留APBF组兔肺组织中eNOS表达下降(P<0.05),而不保留APBF组兔肺动脉组织中eNOS表达较部分保留APBF组进一步下降(P<0.05);而且Western blot检测结果显示:与完全保留APBF组及空白对照组比较,部分保留APBF组兔肺组织中ET-1蛋白表达上调(P<0.05),而不保留APBF组兔肺动脉组织中ET-1蛋白表达进一步上调(P<0.05)。结论APBF对肺血管内皮功能有一定的保护作用。Objective To investigate the protective effect of anterior pulmonary blood flow(APBF)on pulmonary vascular endothelial function during bidirectional Glenn shunt.Methods Bidirectional Glenn shunt model was established in rabbits and divided into three groups(n=5)according to the degree of interruption of the main pulmonary artery:APBF group(no ligation of main pulmonary artery),partial interruption of APBF group(ligation of main pulmonary artery to 0.71 of its diameter),complete interruption of APBF group(ligation of main pulmonary artery);and non-surgical rabbits were used as control group.After successful modeling,rabbits were raised for three months for reconstruction of tissue and organ,and then the lung tissues in all groups were collected for immunohistochemistry to detect the changes of endothelial nitric oxide synthase(eNOS)and elastin in the intima of pulmonary artery.Western blot was used to detect the expression levels of eNOS and endothelin-1(ET-1)in lung tissues.Results The expression of eNOS in pulmonary artery intima was lower in partial interruption of APBF group than in APBF group and control group(P<0.05),while the expression of eNOS in pulmonary artery intima in complete interruption of APBF group was further lower than in partial interruption of APBF group(P<0.05).The expression of elastin in pulmonary artery in partial interruption of APBF group was higher than that in APBF group and control group(P<0.05),while the expression of elastin in pulmonary artery in complete interruption of APBF group was higher than that in partial interruption of APBF group(P<0.05).The expression of eNOS in lung tissue was lower in partial interruption of APBF group than in APBF group and control group(P<0.05),while the expression of eNOS in lung tissue in complete interruption of APBF group was further lower than in partial interruption of APBF group(P<0.05).The expression of ET-1 in pulmonary artery intima in partial interruption of APBF group was higher than that in APBF group and control group(P<0.05),while the

关 键 词：双向Glenn分流术 动物模型 弹力蛋白 内皮功能 

分 类 号：R543[医药卫生—心血管疾病]