硝普钠结合控制性再灌注预防肺缺血再灌注损伤的实验研究  

Experimental study of sodium nitroprusside and controlled reperfusion preventing pulmonary reperfusion injury

作　　者：许崇武[1] 李野[1] 王雪峰[1] 王柏春[1] 

机构地区：[1]哈尔滨医科大学第一临床医学院胸心外科,黑龙江哈尔滨150001

出　　处：《哈尔滨医科大学学报》2004年第2期166-168,共3页Journal of Harbin Medical University

摘　　要：目的　探讨硝普钠结合控制性再灌注在预防肺缺血再灌注损伤中的作用及其机制。方法　将 1 4只猪随机分为对照组 (Ⅰ组 )和实验组 (Ⅱ组 )。对照组在去除肺动脉阻断 ,恢复自体血流前 ,给予控制性再灌注处理 (灌注液 :去白细胞∶改良Buckberg液 =4∶1 ,灌注压 1 8mmHg ,灌注时间 1 0min ,温度 37℃± 1℃ )。实验组在去除肺动脉阻断 ,恢复自体血流前 ,给予控制性再灌注 ,后经肺动脉以每分钟 1 .0 μg kg注入硝普钠 1 0min ,余处置同对照组。 0 .5 ,1和 2h后测血氧分压、肺血管阻力、肺顺应性及肺氧合功能变化 ,实验结束后 ,取肺组织测NO含量、MDA含量及肺含水量。结果　实验组的左肺氧合功能和肺顺应性明显好于对照组 (P <0 .0 5 )。肺循环阻力、丙二醛 (MDA)值及肺含水量均低于对照组 (P <0 .0 1 )。实验组肺中NO含量较对照组明显升高 (P <0 .0 1 )。结论　硝普钠结合控制性再灌注能明显降低肺缺血再灌注损伤 。Objective To study the sodium nitroprusside and controlled reperfusion in the lung reperfusion injury and possible mechanism.Methods Fourteen pigs were randomly divided into 2 groups.Controlled group(groupⅠ) underwent controlled reperfusion,which performed by mixing leukocyte depleting blood with a crystalloid solution(leukocyte depleting blood:modified buckberg perfusate=4∶1),and perfuse into the graft lung for 10 minutes at lower pressure of 18 mmHg and temperature of 37℃±1℃ before removing the pulmonary artery clamp.The experimental group(groupⅡ)underwent sodium nitroprusside and controlled reperfusion,which performed by the injection of sodium nitroprusside and else treatment was same as the controlled group.Function of left lung was assessed at 0.5,1 and 2h after analogue transplantation.After finishing the trail,the pulmonary tissue edema were calcuclated and the contents of NO and MDA in the left lungs were determined.Results The functions of lung in groupⅡ was significantly better than in the groupⅠ( P <0.01).GroupⅡminimized the reperfusion injury,increased NO(114.41±6.77 versus 56.67±7.42μmol/L, P <0.01) and lowered MDA(17.32±1.81 versus 23.82±3.21nmol/mg prot, P <0.01) and tissue edema (83.3±0.2 versus 87.2 ±0.4, P <0.01).Conclusion Sodium nitroprusside and controlled reperfusion can significantly attenuate pulmonary reperfusion injury and have a protective effect on the lung.

关 键 词：硝普钠 肺缺血 预防措施 再灌注损伤 肺移植 治疗 

分 类 号：R563[医药卫生—呼吸系统]