肺动脉灌注含氧血对肺损伤的保护作用

Effect of Continuous Pulmonary Artery Perfusion with Oxygenated Blood on Lung Vascular Endothelial Cell Injury During Cardiopulmonary Bypass

【目的】探讨体外循环(CPB)期间含氧血持续肺动脉灌注对CPB中肺损伤的保护作用。【方法】30例行二尖瓣置换术病人随机分成肺灌注组15例,对照组15例。肺灌注组病人CPB术中采用含氧血肺动脉持续灌注,对照组常规行二尖瓣置换术,未行肺动脉灌注。于CPB结束30min,取右上肺小块肺组织作冰冻切片免疫组化检测肺血管内皮细胞粘附分子(ICAM1)、内皮源型一氧化氮合酶(eNOS)、诱生型一氧化氮合酶(iNOS)的表达。【结果】肺灌注组ICAM1、iNOS表达明显弱于对照组(P<0.01),肺灌注组eNOS表达明显强于对照组(P<0.01)。【结论】CPB中含氧血持续肺动脉灌注对CPB中肺损伤有保护作用。

[Objective]To study the effect of continuous pulmonary artery perfusion with oxygenated blood on lung vascular endothelial cell injury during cardiopulmonary bypass(CPB).[Methods]Thirty cases undergoing mitral valve replacement were randomly divided into control group (n=15) and lung perfusion group (n=15). The cases in the lung perfusion group were perfused with oxygenated blood continuously to the pulmonary artery during CPB. The cases in the control group were performed the routine procedure of mitral valve replacement. Lung biopsy specimens were obtained at 30min after CPB. The expression of ICAM-1,eNOS and iNOS were meatured by the immunohistochemical technigue.[Results]The expression of ICAM-1 and iNOS in lung purfusion group was lower than in control group, while the expression of eNOS in lung perfusion group was stronger than in control group (P<0.01).[Conclusion]Continuous pulmonary artery perfusion with oxygenated blood during CPB demonstrates the protection of lung vascular endothelial cell.