体外循环中康斯特保护液肺动脉灌注的肺保护作用

Experimental Study on Protective Effect of HTK Solution on Lung Injury during Extracorporeal Circulation

目的采用体外循环下肺动脉灌注动物模型观察康斯特保护液（HTK液）对体外循环所致肺损伤的保护作用。方法20只大耳白兔,体重2.5-3Kg,随机分为对照组（体外循环组）;实验组（体外循环＋HTK液肺动脉灌注组）。于麻醉后、复跳60min、90min时抽取血样检测髓过氧化物酶（MPO）、丙二醛（MDA）和细胞因子白介素-6（IL-6）、白介素-8（IL-8）浓度。实验结束后取肺组织作干湿比检测并作光镜和电镜检查。结果实验组MPO、MDA和IL-6在复跳60min、90min时浓度均低于对照组,其中90min时差异显著（P〈0.05）;IL-8浓度低于对照组,但无显著差异（P〉0.05）;实验组肺组织干湿比低于对照组（P〈0.05）;光、电镜结果显示：实验组肺组织病理改变明显轻于对照组。结论HTK液肺动脉灌注能明显抑制体外循环引起的炎症反应,减轻体外循环所造成的肺损伤。

OBJECTIVE To observe the protective effect of HTK solution on lung injury after extracorporeal circulation（ECC）.METHODS 20 rabbits were randomly divided into two groups： control group（ECC group） and protective group（ECC＋HTK group）.Plasma myeloperoxidase（MPO）,malondialdehyde（MDA） and cytokine of interleukin6（IL-6）,interleukin-8（IL-8） in left atrium blood were measured after anesthesia,60 min and 90 min after aorta declamped.Lung biopsies were also performed after operation.Light microscope and transmission electron microscopy were used to cast lung injury of the two groups.RESULTS The plasma levels of MPO and MDA in protective group was lower than that in control group at 60 min and 90 min after aorta declamped,and the difference was significant（P〈0.05） at 90 min after aorta declamped.The plasma levels of IL-8 in control group was higher than that in protective group,however the difference was not significant（P〉0.05）.The lung wet-to-dry ratio of control group was higher than that of protective group and the ratios were significantly different between groups（P〈0.05）.The light microscopic analyses and transmission electron microscopy demonstrated that in control group lung damage was severer than the protective group.CONCLUSION HTK solution can distinctly inhibit inflammatory responses caused by ECC.Thus we conclude that HTK solution can ameliorate lung function and attenuate lung injury after ECC.