不同肺保护液对肺移植肺保护过程中肺损伤的保护作用

Effect of Different Pulmonary Preservative Fluid on Pulmonary Surfactant of Donor Lungs

目的:研究不同肺保护液行供体肺保护后对肺表面活性物质(PS)的影响。方法:36只新西兰大白兔随机分组,低钾右旋糖酐液组(LPD液组)、Euro-Collins液组(EC液组)和正常对照组,每组6对供受体共12只。建立异位肺移植模型,分别以4℃的LPD液和EC液再灌注供体肺30分钟后,对肺泡灌洗液中肺表面活性物质各组成成分用放射性免疫分析法、薄层色谱分析法、Lowry法、抗坏血酸法进行分析;同时测定平均肺动脉压、呼吸道峰压、供体肺干湿比(W/D比),并行血气分析和检查。结果:LPD液组和EC液组二棕榈酸磷脂酰胆碱与总磷脂的比值显著低于对照组(P<0.05),且EC液组显著低于LPD液组(P<0.05);LPD液组和EC液组白介素-1,白介素-2,白介素-6,白介素-8与总蛋白的比值显著高于对照组(P<0.05),且EC液组显著高于LPD液组(P<0.05)。这些改变与血氧分压,血二氧化碳分压,平均肺动脉压,呼吸道峰压,W/D比改变相一致。结论:LPD液较EC液有更好的肺保护效果;肺表面活性物质的多种组成成分可作为评价移植肺保护过程中肺损伤的标志物。

Objective：To study the effect of different pulmonary preservative fluids on the pulmonary surfactant production of the donor lungs after isolation and reperfusion. Methods：Thirty-six rabbits were randomly divided into 3 groups, LPD fluid group, EC fluid group and normal control group. The isolated lung transplantation and reperfusion model was established. Pulmonary surfactant in alveolar lavage fluid after reperfusion,blood gas, mPAP,PAWPand the W/D ratio were examined. Resuhs：The ratio of DPPC over total phospho-lipid （TPL）in LPD group and EC group was higher than that in the normal control group. The ratio of DPPC over TPL in EC group was higher than that in LPD group. The ratio of IL-1β,IL-2,IL-6,IL-8 over total protein （TPr） in LPD group and EC group was higher than that in the normal control group ; The ratioes of IL-113, IL-2, IL-6,1L-8 over TPr in EC group were higher than those in the I,PD group. These changes were consistent with the changes of PO2, PCO2, mPAP, PAw P, and W/D ratio. Conclusion：LPD fluid has better pulmonary protective function than EC fluid. Some components of pulmonary surfactant could serve as the markers for measuring pulmonary injury during pulmonary protection.