吸入一氧化氮对兔缺血-再灌注肺血流动力学和气体交换影响的实验研究

Effect of inhaled nitric oxide on the gas exchange and hemodynamic of ischemia-reperfusion lung in rabbit model

目的 :评价吸入一氧化氮 (NO)对缺血 -再灌注兔肺血流动力学和气体交换的影响。方法 :40只健康新西兰大白兔随机分成 4组 ,每组 10只。Ⅰ假手术组 ;Ⅱ假手术 +吸入NO ;Ⅲ缺血 -再灌注组 ;Ⅳ缺血-再灌注 +吸入NO组。Ⅱ、Ⅳ组吸入NO 5 0× 10 -6。再灌注 2 40min连续动态观察肺动脉压 (PA)、肺血管阻力(PVR)、氧分压 (PaO2 )、二氧化碳分压 (PaCO2 )、肺泡动脉血氧差 (A -aDO2 )、肺内动静脉分流 (Qs/Qt)、外周白细胞数、CD18的表达、高铁血红蛋白。结果 :(1)吸入NO不影响正常兔肺血流动力学和气体交换功能。 (2 )肺再灌注时早期吸入NO后PaO2 上升 ,PA、PVR、PaCO2 、A -aDO2 、Qs/Qt下降 ,CD18的表达及外周白细胞数无明显变化。(3)吸入NO对高铁血红蛋白的升高无明显影响。结论

AIM:To evaluate the effect of pulmonary gas exchang and hemodynamic by inhaled nitric oxide on ischemia-reperfusion(I/R) lung in rabbit model.METHODS:Forty Newzealand rabbits were divided into four groups: group Ⅰ, sham-operated; group Ⅱ, sham-operated with inhaled nitric oxide (NO); group Ⅲ, I/R; group Ⅳ, I/R with Inhaled NO. Pulmonary artery pressure (PA), pulmonary vascular resistance(PVR), arterial oxygen tension(PaO 2), arterial carbon dioxide tension (PaCO 2), alveolar-arterial gradient (A-aDO 2), Shunt fraction (Qs/Qt) expression of CD 18, peripheral leukocyte, methemoglobin were continuetly quantitated. RESULTS:At the start of reperfusion inhaled NO significantly improved PaO 2 and decreased PA, PVR,PaCO 2,A-aDO 2,Qs/Qt.CONCLUSION:Inhaled NO ameliorated significantly the early gas exchange and hemodynamic of reperfusion lung.