含银杏叶提取物的肺保护液对供体肺保护作用的实验研究

THE PROTECTIVE EFFECT OF GINKGO BILOBA EXTRACT CONTAINED LUNG PRESERVATION SOLUTION WITH A NEW ANIMAL MODEL

目的探讨含银杏叶提取物的肺保护液对供体肺的保护作用。方法新西兰白兔30只,随机分为对照组、低钾右旋糖酐液(LPD液)组和银杏叶提取物(GBE)组,每组10只。建立兔在体肺缺血冷保存再灌注损伤动物模型,对照组仅阻断左肺门和冷藏,不灌肺保护液,LPD液组、GBE组分别经左肺动脉置管在体灌注LPD肺保护液和含银杏叶提取物的LPD肺保护液,之后将左肺在体低温(10℃)冷藏2小时后开放肺门再灌注2小时。分别于肺门阻断前、再灌注5分钟、2小时取经肺静脉置管取肺静脉血标本,行血气分析;分别于缺血前取左肺上叶正常组织及肺门开放前、开放后2小时取左肺下叶肺组织,H-E染色观察组织病理学改变;同时检测支气管灌洗液中性粒细胞百分比和肺湿/干重比。结果各组在缺血前相比,肺静脉血氧分压均无显著性差异;GBE组在再灌注5分钟和2小时两个时间点均显著高于对照组(P<0.01)和LPD组(P<0.05)。病理切片GBE组肺泡出血及肺结构损害分级显著轻于对照组及LPD组。GBE组支气管灌洗液中性粒细胞百分比明显低于LPD液组及对照组。肺湿/干重比GBE组显著低于对照组和LPD液组。结论含银杏叶提取物的肺保护液可明显减轻肺缺血再灌注损伤,对保存缺血肺组织有显著的保护作用。

Objective To explore the protective effect of Ginkgo Biloba Extract （GBE） contained lung preservation solution with rabbit in situ lung preservation model. Methods Thirty New Zealand rabbits were divided randomly into 3 groups, 10 in each group. In group A （control group）, the left lung hilus was clamped without solution perfusion. In group B （LPD group） and group C （GBE＋ LPD group）, the lungs were perfused with LPD solution and GBE contained LPD solution, respectively. The lungs in all groups were stored at 10℃ in a specially made lung preservation container for 2 hours and then unclamped the lung hilus to reperfuse the lung for 2 hours. Pulmonary venous blood samples were collected at pre- clamping the lung hilus, 5 minutes and 2 hours after reperfusion for blood gas analysis. Biopsy of lung tissue was excised for morphological examination at pre- declamping the lung hilus, 2 hours after ischemia and 2 hours after reperfusion. Examination of bronchoalveolar lavage fluid was taken for the evaluation of inflammation status. Left lung wet/dry weight ratio was detected to compare the degree of lung edema. Result： There was no significant difference of the partial oxygen pressure of pulmonary venous blood （PvPO2） among the 3 groups before ischemia. PvPO2 in group C at 5 minutes and 120 minutes after reperfusion was significantly higher than that in group A （P〈0.01） and group B（P〈0.05）, respectively. The morphological lesion was more severe in group A and B than that in group C, respectively. The PMN percentage in bronchoalveolar lavage fluid in group A and group B was significantly higher than that in group C. Left lung wet/dry weight ratio in group C was significantly lower than those in group A and group B, respectively. Conclusion：GBE contained lung preservation solution can significantly reduce the lung ischemia reperfusion injury.