滚压泵建立猪肺持续灌注与缺血再灌注模型

Establishment of porcine isolated lung ischemia perfusion model and continuous perfusion model using roller pump

目的:通过滚压泵建立一种操作简单的猪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:18只乳猪随机分为对照组,缺血再灌注(IR)组和非搏动持续灌注(NCP)组,每组6只.分别在右心房、左心房和肺动脉插管,灌注前引流全部血液入贮血器.将贮血器中灌注液通过滚压泵泵入肺动脉,灌注双肺后再通过左心房插管将灌注液引回贮血器,从而建立猪肺灌注模型.对照组双肺保持生理灌注120min;IR组双肺缺血90min后,滚压泵灌注30min;NCP组滚压泵持续灌注双肺120min.测定实验0min和120min时肺静态顺应性以及灌注液中TNF-α,IL-6浓度.实验后测定肺组织湿干比并进行光镜和电镜观察.结果:与0min相比,IR组肺顺应性(P<0.05)下降,灌注液TNF-α(P<0.05)和IL-6浓度(P<0.05)升高.120min时,NCP组肺顺应性(P<0.05)和湿干比(P<0.05)均优于IR组.IR组灌注液TNF-α(P<0.05)高于NCP组.NCP组光镜和电镜下的肺损伤程度轻于IR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;非搏动持续性灌注较之缺血再灌注对肺的损伤更轻.

AIM： To observe if the ischemia-reperfusion （IR） injury to the lung is more serious than the continuous perfusion injury to the lung by establishing a new isolated lung perfusion model in piglets using a roller pump. METHODS： Eighteen piglets were randomly divided into control group, IR group and nonpulsatile continuous perfusion （NCP） group, with 6 in each group. Three catheters were respectively inserted into the right atrium, left atrium and main pulmonary artery. The whole blood was drained into the resevior through the right atrium catheter before the lung perfusion. The perfusion solution in reservior 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 control group, the lung was perfused by the heart at a physiological state for 120 rain. In IR group, the lung perfusion started after 90 min ischemia and the perfusion lasted 30 min at the flow of 80 mL/kg· rain. In NCP group, the lungs were continuously perfused by the roller pump at the same flow for 120 min. The lung compliance, the contents of TNF-α and IL-6 in the perfusate were measured at the time points of 0 min and 120 rain. The lung wet to dry weight ratio （W/D） was determined after perfusion. Histological and ultrastructural changes of the lung were also examined after experiment. RESULTS： In IR group, compared to the parameters at 0 min, the lung compliance was lower （ P 〈 0. 05 ）, and the contents of TNF-α and IL-6 were higher （ P 〈 0.05 ）. At 120 min, the lung compliance and the W/D in NCP group were significantly better than those in IR group （ P 〈 0.05 ）. The contents of TNF-α （ P 〈 0.05 ） in IR group were significantly higher than that in NCP group. It also showed milder lung injury in NCP group through light and electron microscope examination. CONCLUSION：The results bears out that the continuous peffusion injury is milder than the ischemia-peffusion injury to the lung, and the convenient operation indicates this model＇s reliability and feasibility.