卡托普利在肺保存中的作用

The application of Captopril in the lung preservation

目的 研究卡托普利在肺保存中的作用及可能的作用机制。方法 将猪分为 2组 ,对照组用 4℃改良的Euro Colling液 (E C液 )对供肺进行灌洗和保存 ,实验组用 4℃含卡托普利 (5 0 0μmol/L)的E C液对供肺进行灌洗和保存 ,然后进行左肺移植。在再灌注后0 .5、1和 2h采血及肺组织 ,测定血氧分压、肺血管阻力、NO2 -/NO3 -含量、超氧化物歧化酶 (SOD)的活性以及脂质过氧化产物丙二醛 (MDA)的含量。结果 实验组的左肺氧合功能明显好于对照组 ,肺循环阻力及肺含水量也较对照组相应时间低 ,差异均有显著性 ;实验组在此期间的NO2 -/NO3 -含量较对照组有明显升高 (P<0 .0 1) ,但肺组织中的SOD活性及MDA含量变化不大。结论 卡托普利对供肺有较好的保护作用 ,能降低移植后肺循环阻力及肺含水量 ,对NO升高有一定作用 。

Objective To study the application of Captopril in the lung preservation and possible mechanism.Methods We used a pig left allotransplantation model to evaluate the effect of Captopril. Twenty minipigs were randomly divided into 2 groups: In the group I, the donor lungs were flushed with Euro Collins solution (EC), and in the group II, the lungs were flushed with EC with Captopril (500?μmol/L). After 4 h preservation at 4?℃, the left lungs were implanted into the recipient animals. Function of the left lung was assessed during temporary (5?min) occlusion of the contralateral pulmonary artery with both lungs being ventilated with 100% oxygen. This assessment was performed at 0.5 , 1 and 2?h after transplantation.Results The arterial oxygen tension in the group II was significantly greater than in the group I ( P < 0.01 ). The change of superoxide dismutase (SOD) and malondialdehyde (MDA) in lung tissue was consistent.Conclusion Captopril could effectively protect the donor lungs, improve the lung function during implantation. The decreased severity of ischemia reperfusion injury and increased nitric oxide content were likely the main mechanisms.