CAJ | 학술논문

目的评价脑死亡供体鼠吸入一氧化碳(CO)对受体鼠移植肺损伤的影响.方法雄性Wistar大鼠24只,体重250～300 g,随机分为3组(n=8),接受非脑死亡供体肺组(NBD组)供体鼠颅内置入Fogarty导管,但不诱导脑死亡,观察2.5 h;接受吸入氧气的脑死亡供体肺组(BDO2组)供体鼠确认脑死亡后吸入40%氧气2 h;接受吸入CO的脑死亡供体肺组(BDCO组)供体鼠确认脑死亡后吸入40%氧气和0.025%CO混合气2 h.处理结束后取供体左肺,进行原位异体肺移植,受体鼠每30 min进行一次动脉血气分析.肺移植成功后2 h处死受体鼠,采集右股动脉血样,采用嘌呤氧化酶法测定血浆超氧化物歧化酶(SOD)活性;采用硫代巴比妥酸法测定丙二醛(MDA)浓度;采用ELISA法测定血浆白细胞介素(IL)-6、肿瘤坏死因子(TNF)-α和IL-10浓度.计算移植肺组织湿/干重比(W/D);测定移植肺组织髓过氧化物酶(MPO)活性,并进行移植肺组织损伤评分.结果与C组比较,BDO2组和BDCO组PaO2/FiO2、BE、pH值和血浆SOD活性、IL-10浓度降低,移植肺组织W/D、MPO活性、损伤评分和血浆MDA、IL-6、TNF-α浓度升高(P<0.05);与BD02组比较,BDCO组PaO2/FiO2、BE、pH值和血浆SOD活性、IL-10浓度升高,移植肺组织W/D、MPO活性、损伤评分和血浆MDA、IL-6、TNF-α浓度降低(P<0.05).结论脑死亡供体鼠吸入CO 2 h可减轻受体鼠移植肺损伤,其机制可能是吸入CO提高了移植肺的抗氧化能力,减轻了移植后局部和全身炎性反应.
목적 평개뇌사망공체서흡입일양화탄(CO)대수체서이식폐손상적영향.방법 웅성Wistar대서24지,체중250～300 g,수궤분위3조(n=8),접수비뇌사망공체폐조(NBD조)공체서로내치입Fogarty도관,단불유도뇌사망,관찰2.5 h;접수흡입양기적뇌사망공체폐조(BDO2조)공체서학인뇌사망후흡입40%양기2 h;접수흡입CO적뇌사망공체폐조(BDCO조)공체서학인뇌사망후흡입40%양기화0.025%CO혼합기2 h.처리결속후취공체좌폐,진행원위이체폐이식,수체서매30 min진행일차동맥혈기분석.폐이식성공후2 h처사수체서,채집우고동맥혈양,채용표령양화매법측정혈장초양화물기화매(SOD)활성;채용류대파비타산법측정병이철(MDA)농도;채용ELISA법측정혈장백세포개소(IL)-6、종류배사인자(TNF)-α화IL-10농도.계산이식폐조직습/간중비(W/D);측정이식폐조직수과양화물매(MPO)활성,병진행이식폐조직손상평분.결과 여C조비교,BDO2조화BDCO조PaO2/FiO2、BE、pH치화혈장SOD활성、IL-10농도강저,이식폐조직W/D、MPO활성、손상평분화혈장MDA、IL-6、TNF-α농도승고(P<0.05);여BD02조비교,BDCO조PaO2/FiO2、BE、pH치화혈장SOD활성、IL-10농도승고,이식폐조직W/D、MPO활성、손상평분화혈장MDA、IL-6、TNF-α농도강저(P<0.05).결론 뇌사망공체서흡입CO 2 h가감경수체서이식폐손상,기궤제가능시흡입CO제고료이식폐적항양화능력,감경료이식후국부화전신염성반응.
Objective To investigate the effects of carbon monoxide (CO) inhalation by brain death (BD) donor on transplanted lung injury in recipient of rats. Methods Twenty-four male Wistar rats weighing 250-300 g were randomly divided into 3 groups ( n = 8 each) : group Ⅰ donor without brain death (NBD) ; group Ⅱ brain death donor inhaling O2 (BDO2) and group Ⅲ brain death donor inhaling CO (BDCO). The donor rats were anesthetized with intraperitoneal pentobarbital sodium 60 mg/kg, trachoostomized and mechanically ventilated (VT 10 ml/kg, RR 50 bpm, PEEP 2 cm H2O). BD was induced by inserting a Fogarty catheter into the skull and brain was compressed by inflating the balloon according to Avlonitis VS. After BD was confirmed, 40% O2 was inhaled for 2 h in group Ⅱ and a mixture of 40% O2 + 0.025% CO was inhaled for 2 h in group Ⅲ . MAP was maintained at 80-100 mm Hg. Cuff technique was used for orthotopic left lung transplantation according to Mizobuchi T.Arterial blood samples were obtained every 30 min in recipient for blood gas analysis. The recipients were killed by exsangmnation at 2 h after lung transplantation and blood was collected for determination of SOD activity and MDA, IL-6, IL-10 and TNF-α concentrations. The transplant lung was removed for determination of W/D lung weight ratio, MPO activity in the lung tissue and microscopic examination. Lung injury scores were calculated. Results PaO2/FiO2, BE, pH, plasma SOD activity and IL-10 concentrations were significantly lower while W/D lung weight ratio, MPO activity in the lung tissue and lung injury scores of the transplant lung were significantly higher in group BDO2 and BDCO than in group (NBD). PaO2/FiO2, BE, pH, plasma SOD activity and IL-10 concentration were significantly higher and W/D ratio, MPO activity in the lung tissue, lung injury scores of the transplant lung and plasma concentrations of MDA, IL-6 and TNF-α were significantly lower in group BDCO than in group BDO2. Conclusion Inhalation of CO for 2 h by BD transplant donor can attenuate the donor lung injury after transplantation in recipient by suppression of local and systemic inflammatory response and enhancing anti-oxidant activity.