中华器官移植杂志
中華器官移植雜誌
중화기관이식잡지
CHINESE JOURNAL OF ORGAN TRANSPLANTATION
2013年
5期
294-298
,共5页
龙小毛%李香伟%林辉%周一凡
龍小毛%李香偉%林輝%週一凡
룡소모%리향위%림휘%주일범
猪%肺%器官保存
豬%肺%器官保存
저%폐%기관보존
Swine%Lung%Organ preservation
目的 观察氧合血体外持续灌注对离体猪肺的保护作用.方法 将低钾右旋糖酐葡萄糖液(Perfadex液)单次经肺动、静脉灌注后的猪肺分为低温保存组(对照组)与氧合血体外持续灌注组(实验组),保存12 h后,将两组猪肺与体外灌注系统和呼吸机连接,模拟体内正常肺工作6h,检测肺血管阻力(PVR)、肺通气阻力(LR)、左下肺静脉血氧分压(PaO2)及肺含水量等肺功能指标,并观察肺组织损伤,检测肺组织中前炎症因子白细胞介素1β(IL-1β)的表达量.结果 两组肺PVR、LR及肺含水量随肺工作时间的延长均逐渐上升,PaO2逐渐下降；但相同时间点,实验组PVR及LR显著低于对照组(P＜0.05),PaO2高于对照组(P＜0.05).与正常肺组织比较,实验组和对照肺组织水肿分级的差异均有统计学意义(P＜0.01),实验组肺水肿分级显著低于对照组(P＜0.05)；实验组和对照组肺组织中IL-1βmRNA的相对表达量分别为0.422±0.132和0.578±0.163,两组差异有统计学意义(P＜0.05).结论 单纯采用氧合血体外持续灌注是可行的供肺保存技术,可减轻低温保存所致供肺的时间依赖性缺血再注损伤,但仍需在完全生理状态下进行更系统的评价.
目的 觀察氧閤血體外持續灌註對離體豬肺的保護作用.方法 將低鉀右鏇糖酐葡萄糖液(Perfadex液)單次經肺動、靜脈灌註後的豬肺分為低溫保存組(對照組)與氧閤血體外持續灌註組(實驗組),保存12 h後,將兩組豬肺與體外灌註繫統和呼吸機連接,模擬體內正常肺工作6h,檢測肺血管阻力(PVR)、肺通氣阻力(LR)、左下肺靜脈血氧分壓(PaO2)及肺含水量等肺功能指標,併觀察肺組織損傷,檢測肺組織中前炎癥因子白細胞介素1β(IL-1β)的錶達量.結果 兩組肺PVR、LR及肺含水量隨肺工作時間的延長均逐漸上升,PaO2逐漸下降；但相同時間點,實驗組PVR及LR顯著低于對照組(P＜0.05),PaO2高于對照組(P＜0.05).與正常肺組織比較,實驗組和對照肺組織水腫分級的差異均有統計學意義(P＜0.01),實驗組肺水腫分級顯著低于對照組(P＜0.05)；實驗組和對照組肺組織中IL-1βmRNA的相對錶達量分彆為0.422±0.132和0.578±0.163,兩組差異有統計學意義(P＜0.05).結論 單純採用氧閤血體外持續灌註是可行的供肺保存技術,可減輕低溫保存所緻供肺的時間依賴性缺血再註損傷,但仍需在完全生理狀態下進行更繫統的評價.
목적 관찰양합혈체외지속관주대리체저폐적보호작용.방법 장저갑우선당항포도당액(Perfadex액)단차경폐동、정맥관주후적저폐분위저온보존조(대조조)여양합혈체외지속관주조(실험조),보존12 h후,장량조저폐여체외관주계통화호흡궤련접,모의체내정상폐공작6h,검측폐혈관조력(PVR)、폐통기조력(LR)、좌하폐정맥혈양분압(PaO2)급폐함수량등폐공능지표,병관찰폐조직손상,검측폐조직중전염증인자백세포개소1β(IL-1β)적표체량.결과 량조폐PVR、LR급폐함수량수폐공작시간적연장균축점상승,PaO2축점하강；단상동시간점,실험조PVR급LR현저저우대조조(P＜0.05),PaO2고우대조조(P＜0.05).여정상폐조직비교,실험조화대조폐조직수종분급적차이균유통계학의의(P＜0.01),실험조폐수종분급현저저우대조조(P＜0.05)；실험조화대조조폐조직중IL-1βmRNA적상대표체량분별위0.422±0.132화0.578±0.163,량조차이유통계학의의(P＜0.05).결론 단순채용양합혈체외지속관주시가행적공폐보존기술,가감경저온보존소치공폐적시간의뢰성결혈재주손상,단잉수재완전생리상태하진행경계통적평개.
Objective To study the protective effect of normothermic ex vivo perfusion to prevent donor-lung injury.Method After being flushed with perfadex solution through the pulmonary artery and vein,the donor lungs were divided to control group (preserved with 4℃ cold static preservation,n =8) and experimental group (preserved with ex vivo oxygenated blood continuous perfusion,n =8).Pulmonary function indexes,including pulmonary vascular resistance (PVR),lung ventilation resistance(LVR),the left inferior pulmonary vein(LIPV) blood PO2,and lung water content,were evaluated.Lung injury were studied by light microscopic observation and detecting the expression of proimflammatory factor IL-1β was detected.Result (1) Lung function evaluation:in both group,PVR,LVR and lung water content gradually increased,LIPV PO2 gradually declined;But in the same time point PVR and LVR in group were were significantly less than in control group (P＜0.05),LIPV PO2 in experimental group were were significantly more than in control group(P＜0.05).(2)Lung injury evaluation:Lung tissue edema classification in both group were significantly higher than in normal lung(P＜0.05),but classification in experimental group were significantly lower than in control group(P＜0.05).The expression of IL-1β in experimental group (0.422 ± 0.132) were significantly lower than in control group(0.578 ± 0.163,P＜0.05).Conclusion Ex vivo oxygenated blood continuous perfusion without ventilator is a feasible technique for lung preservation.It ameliorates hypothermic time-dependent ischemic injury.But further systems evaluation in complete physiologic condition is necessary.
