无泵驱动体外膜肺转流治疗急性呼吸衰竭犬过程中血浆和肺组织ET-1、TNF-α水平的变化

Changes of ET-1 and TNF-α in dog ARF model during bilateral femoral arteriovenous shunt for extracorporeal membrane oxygenation

目的观察双侧股动脉-股静脉无泵驱动体外膜肺(bAV-ECMO)治疗急性呼吸衰竭(ARF)犬过程中血浆和肺组织肿瘤坏死因子-α(TNF-α)和内皮素-1(ET-1)的变化。方法10只犬在建立ARF模型情况下给予bAV-ECMO治疗。分别于实验各时段提取肺组织及血浆,应用放射免疫技术检测TNF-α、ET-1的变化。结果模型动物血浆ET-1含量先降低,1 h后开始回升,2 h达到高值;肺组织匀浆ET-1含量增加在转流2 h达到高值。方差分析表明匀浆和血浆各自ET-1的均数在转流前后有显著性差异(P<0.05)。肺组织匀浆和血浆TNF-α含量转流3 h后均较术前有所增高,但都呈现出先降低后升高的趋势。方差分析表明匀浆和血浆中各自TNF-α的均数在转流前后有显著性差异(P<0.05)。结论bAV-ECMO早期转流可能减少ET-1的释放;而TNF-α在转流早期对于ET-1释放影响不大。

Objective To study the changes of endothelin-1（ET-1） and tumor necrosis factor alpha（TNFα ） in lung homogenate and plasm when acute respiratory failure （ARF） animal models are treated by bilateral femoral arteriovenous extracorporeal membrane oxygenation（bAV-ECMO）. Methods Ten ARF dog models were treated by the bAV-ECMO. Right atrium blood and lung tissues were collected at different time points, and ET-1 and TNFα were assayed by radioimmunological method. Results ET-1 content in plasm decreased at first, and at 1 h it was elevated and at 2 h reached the peak. ET-1 content in lung homogenate reached the peak at 2 h and then started to decrease. The analysis of variance showed notable differences（P〈0.05）. TNFα content in lung homogenate and plasm decreased at 1 h and started to increase after that time; it was higher at 3 h than that at the beginning of operation and increased continuously. The analysis of variance showed notable differences （P〈0.05）. Conclusion Early bAV-ECMO can possibly reduce the release of ET-1, while TNFα has no obvious effect on ET-1 release during bAV-ECMO.