滚压泵在乳猪肺灌注模型建立中的应用

Application of Roller Pump in Establishing a Piglet Model of Lung Perfusion

目的通过滚压泵建立一种操作简单的猪隔离肺持续灌注和缺血再灌注模型,并比较两种灌注方法对肺的损伤。方法12只乳猪随机分为缺血再灌注组(对照组)和持续灌注组(实验组)。分别在左、右心耳以及肺动脉插管。滚压泵将贮血器中的灌注液泵入肺动脉,灌注双肺后再通过左心耳将灌注液引流回贮血器,建立猪肺灌注模型。对照组双肺停止灌注90min后灌注30min,实验组双肺持续灌注120min,灌注流量均为80mL/kg.min。测定实验前后的肺静态顺应性以及灌注液中TNF-α、IL-6变化。测定肺组织湿干比并进行电镜观察。结果实验组肺静态顺应性(实验组6.14±1.17mL/cmH2O,对照组7.89±0.94mL/cmH2O,p=0.017)、湿干比(对照组5.18±0.97,实验组3.84±1.08,P=0.048)、TNF-α指标均优于对照组(实验组0.80±0.26ng/mL,对照组0.52±0.15ng/mL,P=0.044)(P<0.05),电镜下的肺损伤程度轻于对照组。结论通过滚压泵建立猪肺持续灌注和缺血再灌注模型具有操作简便的特点。持续性非搏动灌注较之缺血再灌注对肺的损伤更轻。

Objective In order to evaluate if ischemia-reperfusion injury to the lung is more serious than the continuous perfusion injury to the lung, we decided to establish a new isolated lung model of piglets by using a roller pump, Methods Twelve piglets were randomly divided into control and experimental groups. Three catheters were inserted into the right atrium, left atrium and main pulmonary artery, respectively. The whole blood was drained into the reservoir through the right atrium catheter before the lung perfusion. The perfusion solution in reservoir was pumped into the main pulmonary artery by a roller pump, and the solution was drained back to the reservoir from the left atrium. In the experimental group, the lungs were continuously perfused by the roller pump with a flow of 80 mL/kg/min for 120 minutes. In the control group, the lungs perfusion started after 90 minutes ceasation and the perfusion lasted 30 minutes at the same flow. The lung compliance and the content of TNF-α and IL-6 in the perfusate were measured at the beginning and at the end of the experiment. The lung wet to dry weight ratio （W/D） was calculated after perfusion. Ultrastructural changes of the lungs were also examined after experiment. Results The lung compliance was 6.14 ±1.17 mL/cm H20 in the experimental group and 7.89±0.94 mL/cm H2O in the control group （P = 0.017）. The W/D ratio was 5.18 ± 0.97 in the control group and 3.84 ± 1.08 in the experimental group （ P = 0.048）, indicating that the W/D ratio in the control group was significantly better than that in the experimental group. The content of TNF-α was 0.80 ± 0.26 ng/mL in the experimental group and 0.52 ± 0.15 ng/mL in the control group （ P = 0.044）, showing the TNF-α content was significantly higher in the experimental group. Milder lung injury was observed in the experimental group by electron microscopic examination. Conclusion The results demonstrate that a continuous perfusion may cause less severe lung injury than the ischemia-reperfusion lung injury. The operation described in this study is convenient to establish the piglet model with high reliability and feasibility.