肺缺血再灌注中血管内皮损伤的研究

Study on capillary endothelium injury in the lung with ischemia-reperfusion

目的 :探讨兔肺缺血再灌注 (I -R)中肺血管内皮细胞的损伤。方法 :比较肺I -R和假手术对照组的血浆一氧化氮 (NO)、内皮素 - 1(ET - 1)及血气、肺水肿指标 ,分析肺脏超微结构。结果 :I -R组血浆NO、ET - 1水平显著高于假手术对照组 ,ET - 1与动脉氧分压 (PaO2 )呈负相关 ,与肺湿 干重比呈正相关。再灌注期 ,PaO2 明显低于对照组 ,肺湿 干重比明显高于对照组。电镜观察 :缺血 1h ,肺毛细血管内皮细胞肿胀 ,Ⅰ型肺泡上皮细胞基膜增厚 ,Ⅱ型细胞微绒毛减少 ,板层小体减少 ,肺泡隔增厚。再灌注 0 5h ,毛细血管和肺泡上皮细胞损伤较明显 ,至再灌注 2h结构开始修复。结论 :I-R时肺毛细血管内皮细胞受损 。

AIM: To confirm the effects of capillary endothelium injury in the lung with ischemia reperfusion. METHODS: The rabbits pulmonary models of ischemia reperfusion (I-R)injury were established. Plasma nitric oxide and endothelin levels, arterial oxygen tension and wet/dry weight ratios were determined in different periods in control and I-R groups, and the pulmonary ultrastructure abnormities were analyzed under electromicroscope. RESULTS: The plasma levels of NO and ET-1 in I-R animals increased significantly ,compared with those in sham treated control groups. The level of ET-1 had significantly negative correlation with PaO 2 and positive correlation with the value of the wet/dry weight ratios. The swelling and karyopyknosis of capillary endothelium in the lung with I-R groups were observed in ischemia periods. The injuries of endotheliums and typeⅠandⅡ alveolar cells in 0 5 h of reperfusion were more severe than those in ischemia time, and the injuries began to repair in 2 h of reperfusion time. CONCLUSION: In the I-R group, pulmonary capillary endothelium have been injuried, which may play a prominent role in I-R injury and dysfunction of the lung.