缺血预处理对犬单肺移植后血液动力学的影响

Effect of ischemic preconditioning on the hemodynamics of canine after lung transplantation

目的 观察供肺缺血预处理对犬肺移植后血液动力学的影响。方法 健康家犬 16条 ,随机分为供肺犬和受肺犬各 8条 ,供肺均经 4℃ Euro- Collin氏液冷灌并保存 3小时 ,其中 4条给予左肺门阻断 10分钟再灌注 15分钟的缺血预处理 (实验组 )。另外 4条无肺门阻断作为对照组。并于移植前后定期观察受体犬血液动力学变化及血浆 TXB2 和 6- keto- PGF1α含量变化。结果 肺移植后 3 0分钟内两组肺动脉压均明显升高 ( P<0 .0 5 ) ,但实验组升高的幅度及维持时程均小于对照组 ( P<0 .0 5 )。两组动物 TXB2 水平均明显升高 ( P<0 .0 5 ) ,对照组更明显 ( P<0 .0 5 )。结论 供肺缺血预处理对稳定肺移植后机体血液动力学有一定作用 ,其机制可能与降低血中 TXA2 的升幅有关。

Objective To study the effects of ischemic preconditioning on the hemodynamics of canine after lung transplantation.Methods Sixteen health canines under butylone anesthesia were randomly assigned to donor canines(n=8)and recipient canine (n=8).Donor lungs were flushed with 4℃ Euro Collins solution and stored in the same solution for 3 hours,and then transplanted to recipient canines,four donors were treated with ischemic preconditioning by occluding left lung hilum for 10 min and releasing for 15 min before being flushed(test group),four donors were collected before and after lung transplantation(control group).The hemodynamics were monitored during the whole procedures,and the blood samples of recipients were taken to measure the plasma concentrations of TXB 2 and 6 keto PGF 1α at various times.Results The pulmonary arterial pressure and plasma TXB 2 level were significantly increased 30 min after lung transplantation compared with those before lung transplantation in both groups(P<0.05).The extent and duration of the increase were less in test group than those in control group(P<0.05).Conclusion Ischemic preconditioning of donor lung can help to maintain the hemodynamics of the recipient after lung transplantation through reducing the rise in the extent of plasma TXA 2 level.