CAJ | 학술논문

目的观察供体犬肺再灌注后早期脂质过氧化反应的变化,了解缺血后处理对供体犬肺植入后功能的影响.方法随机选取12对比咯犬,组成供、受体,随机分成2组.对照组:6对犬,按常规进行供受体左侧异体单肺移植,不予缺血后处理的干预.缺血后处理组:6对犬,进行供受体常规左侧异体单肺移植,再灌注早期实施3个周期的10 s再灌-10 s再阻断、总时程1 min的缺血后处理.于供肺再灌注后1、2 h两个时间点采集供肺标本检测超氧化物歧化酶(SOD)的活性、丙二醛(MDA)的含量.光镜下观察供肺植入后1、2 h两个时间点肺组织的病理变化.结果术后实验犬均存活.植入供体肺平均用时(35.92±1.73)min.缺血后处理组在1、2h时间点的供肺组织SOD活性水平较对照组升高、MDA含量较对照组减低,差异有统计学意义(P<0.05).缺血后处理组肺组织光镜下观察在各时间点的炎症反应均较对照组的变化轻微.结论缺血后处理可以抑制再灌注时氧自由基的堆积,从而减少供肺的缺血冉灌注损伤,改善供肺植入后的功能.
목적 관찰공체견폐재관주후조기지질과양화반응적변화,료해결혈후처리대공체견폐식입후공능적영향.방법 수궤선취12대비각견,조성공、수체,수궤분성2조.대조조:6대견,안상규진행공수체좌측이체단폐이식,불여결혈후처리적간예.결혈후처리조:6대견,진행공수체상규좌측이체단폐이식,재관주조기실시3개주기적10 s재관-10 s재조단、총시정1 min적결혈후처리.우공폐재관주후1、2 h량개시간점채집공폐표본검측초양화물기화매(SOD)적활성、병이철(MDA)적함량.광경하관찰공폐식입후1、2 h량개시간점폐조직적병리변화.결과 술후실험견균존활.식입공체폐평균용시(35.92±1.73)min.결혈후처리조재1、2h시간점적공폐조직SOD활성수평교대조조승고、MDA함량교대조조감저,차이유통계학의의(P<0.05).결혈후처리조폐조직광경하관찰재각시간점적염증반응균교대조조적변화경미.결론 결혈후처리가이억제재관주시양자유기적퇴적,종이감소공폐적결혈염관주손상,개선공폐식입후적공능.
Objective Ischemia-reperfusion injury may occur in the donor lung during lung transplantation. As a response to ischemia-reperfusion injury, ischemic post-conditioning provides an intrinsic protection. The study was aimed at identifying the influ-ence of ischemic post-conditioning on the function of donor lung in dogs by measuring the changes of lipid peroxidation during early reperfusion. Methods Twelve orthotopic left lung transplantations were performed by using 24 paired dogs. The animals were divided randomly into the ischemic post-conditioning group and the control group. For dogs (6 pairs) in the control group, no intervention of ischemic post-conditioning was performed during routine left lung transplantation, for the rest dogs in the ischemic post-conditioning group, 3 cycles of iscbemic post-conditioning with reperfusion(for 10 seconds)-interruption (for another 10 seconds) were performed after implantation of donor lungs obtained routinely. Content of malonaldehyde(MDA) and activity of superoxide dismutase (SOD) in the specimens of donor lungs were measured with Commassie Brilliant Blue 1 and 2 hours after transplantation, respectively. Mean-while, fresh pulmonary specimens obtained at different time points were stained with hematoxylin and eosin(HE). A statistical software SPSS 13.0 was used in the analysis. A significant difference was indicated by P <0.05. Results Transplantations were completed in 12 receiver canis, the mean time for anastomoses was(35.92 ± 1.73)min. The contents of MDA in the experimental group was sig-nificantly lower than that of control gronp(P <0.05)1 and 2 hours after transplantation. The activity of SOD was significantly higher in the experimental group than that of control group 1 and 2 hours after transplantation(P < 0.05). Under the light microscopic exami-nation, the inflammatory changes observed were comparative mild in the ischemic post-conditioning group. Conclusion The accumu-lation of reactive oxygen species induced by canine lung transplantation may be decreased with iachemic post-conditioning, an interven-tion that attenuates damage to the donor lungs and improves their function during ischemia reperfusion.