CAJ | 학술논문

目的探讨低温一氧化碳通气对无心跳大鼠供肺的保护机制.方法 SD大鼠制成无心跳供鼠,分别行常温空气(对照组)、常温一氧化碳(常温一氧化碳组)和低温一氧化碳(低温一氧化碳组)机械通气,并进行大鼠左肺移植.评估无心跳供肺热缺血期间的温度变化,再灌注后测定动脉血氧分压、测定湿/干移植肺组织质量比值(W/D)、髓过氧化物酶(MPO)活性和支气管肺泡灌洗液(BAL)中性粒细胞计数等,同时检测移植肺组织中白细胞介素1β(IL-1β)和胱天蛋白酶3mDNA的表达量.结果低温一氧化碳组的支气管内和肺表面温度低于对照组及常温一氧化碳组(P＜0.01).移植肺再灌注后1、2和4h时低温一氧化碳组的动脉血氧分压显著高于对照组和常温一氧化碳组(P＜0.05).再灌注4h后,低温一氧化碳组的移植肺组织的W/D、MPO活性、BAL中性粒细胞计数值、IL-1β和胱天蛋白酶3mRNA的相对表达量均低于对照组和常温一氧化碳组(P＜0.05).结论低温一氧化碳通气可以加强一氧化碳抑制前炎症因子IL-1β和凋亡相关基因胱天蛋白酶3的表达,更好的减轻无心跳供鼠供肺的热缺血损伤.
목적 탐토저온일양화탄통기대무심도대서공폐적보호궤제.방법 SD대서제성무심도공서,분별행상온공기(대조조)、상온일양화탄(상온일양화탄조)화저온일양화탄(저온일양화탄조)궤계통기,병진행대서좌폐이식.평고무심도공폐열결혈기간적온도변화,재관주후측정동맥혈양분압、측정습/간이식폐조직질량비치(W/D)、수과양화물매(MPO)활성화지기관폐포관세액(BAL)중성립세포계수등,동시검측이식폐조직중백세포개소1β(IL-1β)화광천단백매3mDNA적표체량.결과 저온일양화탄조적지기관내화폐표면온도저우대조조급상온일양화탄조(P＜0.01).이식폐재관주후1、2화4h시저온일양화탄조적동맥혈양분압현저고우대조조화상온일양화탄조(P＜0.05).재관주4h후,저온일양화탄조적이식폐조직적W/D、MPO활성、BAL중성립세포계수치、IL-1β화광천단백매3mRNA적상대표체량균저우대조조화상온일양화탄조(P＜0.05).결론 저온일양화탄통기가이가강일양화탄억제전염증인자IL-1β화조망상관기인광천단백매3적표체,경호적감경무심도공서공폐적열결혈손상.
Objective Lungs from non-heart-beating donors for transplantation require protection against warm ischemic damage.This study investigated the preservative effect of Ventilation with cooled carbon monoxide during warm ischemia in non-heart-beating donor rat lungs.Method 18 rats were divided into a CO group (n =6),which received ventilation with low-dose carbon monoxide at normal temperature during a 4-hour warm ischemic period; a Control group (n =6),which received no ventilation at normal temperature; a cooling CO group (n =6),which received ventilation with cooled carbon monoxide.PaO2,Myeloperoxidase (MPO) activity,Bronchoalveolar lavage (BAL) neutrophil count and the wet-to-dry (W/D) lung weight ratio were recorded in every group.Quantitative real-time RT-PCR was used to analysis the expression of IL-1β and caspase 3 mRNA in graft lung tissures.Result Endobronchial temperatures and lung surface temperatures in the Cooling CO group were lower than those in the corresponding Control group and CO group (P＜ 0.01).Lower wet/dry lung weight ratio,MPO activity,BAL neutrophil count,expression of IL-1β and caspase 3 mRNA in graft lung tissures were seen in the Cooling group compared with the Control group and CO group (P＜0.05).Conclusion Ventilation with cooled carbon monoxise can decrease lung temperature and improve the protecting effect on non-heart-beating donor rat lungs againt worm ischemic injury by inhibiting the expression of proimflammatory factor IL-1β and apoptosis-associated gene caspase 3.