猪自体肺移植模型的建立

Establishment of a swine model of lung auto-transplantation

目的:建立猪自体肺移植实验动物模型,为临床开展自体肺移植术提供实验基础。方法:健康杂种猪18只,分别行左侧第四肋间开胸,游离肺门后行左全肺切除,予修剪左下肺后,将离体的左下肺重新植入胸腔,即把下肺静脉重植于上肺静脉残端,并依次完成支气管和肺动脉吻合。依据术中左下肺叶是否行灌注和灌注液的不同,分为3组,每组6只,分别为:A组(未灌注组)、B组(常温肝素灌注组)及C组(低温Euro-Collins液灌注组)。分别于移植前、移植后0.5、1.0、2.0、4.0h检测移植肺的肺静脉血氧分压(PaO2)、湿干重比(W/Dratio)、氧自由基髓过氧化物酶(MPO)活性;观察移植肺组织的光镜及电镜结构变化。结果:手术无一例失败,均存活。移植前,移植后0.5、1.0、2.0h3组移植肺的肺静脉血PaO2、肺组织的MPO和W/D无显著性差异(P>0.05);与对A组相比,B组和C组移植后4h的PaO2、MPO和W/D均有显著性差异(P<0.05)。与A组相比,B组及C组病理损伤较轻,且两组损伤程度相似。结论:本模型稳定、可靠、重复性好,是研究自体肺移植较为理想的动物模型;常温肝素灌注后的供肺叶能满足自体肺移植的要求。

Objective：To duplicate the swine model of left single lung auto-transplantation on purpose to provide the experimental basis for clinical application.Methods：Eighteen healthy local pigs received left pneumonectomy,then the＂cutdown＂lower lobe was replanted into the thorax with the inferior pulmonary vein transplanted to the proximal stump of the superior pulmonary vein and the bronchus and pulmonary artery anastomosed in turn.They were divided into three groups（6 in each group）：group A（non-perfusion fluid treated group）,group B（normothermic heparin treated group） and group C（Cold Euro-Collins treated group）.The blood sample and lung tissues were collected at baseline,0.5,1,2,and 4 hours after lung auto-transplantation respectively.The indices were determined as follows：the oxygen pressure of pulmonary vein blood,the myeloperoxidase（MPO） content and wet / dry ratio（W / D） of the transplanted lung tissue.The pulmonary grafts were sampled for histological examination and ultra-structure observation under the electronic microscopes.Results：There were no statistical significance of PaO2 levels,MPO content and W / D ratio within the three groups at the time-point of the baseline,0.5,1,or 2 hours after transplantation.Compared with group A,4 hours after transplantation, PaO2 levels,MPO content and W/D ratio had significant difference in group B and C（P 〈 0.05）.Compared with group A,the pulmonary grafts in group B and group C presented less pathological damage and similar degree of injury.Conclusion：This model has satisfactory stability and repeatability.Pulmonary vessel infusion with normothermic heparin meets the requirement of lung auto-transplantation.