抑肽酶对长期低温保存兔肺的保护作用的研究

PROTECTIVE EFFECT OF APORTONIN ON LUNG PRESERVATION

目的 :探讨抑肽酶对长期低温保存兔肺保护作用。方法 :应用离体兔肺缺血再灌注模型 ,15只白兔随机分为三组 (抑肽酶组、对照组 1、对照组 2 ) ,抑肽酶组和对照组 1用Euro -Collins液进行肺灌洗和低温保存(10℃ ,2 4h)后 ,以新鲜兔血离体灌注 30min。抑肽酶组在兔血中加入抑肽酶 (2 5万KIU) ;对照组 1不用抑肽酶。对照组 2取自正常兔肺 ,不进行肺灌洗和保存。灌注中测定肺动脉氧差 (△PO2 ) ,肺动脉压 (PAP) ,灌注完毕取肺电镜观察微观结构。应用TUNEL(末端脱氧核糖核酸转移酶 (TdT)介导的dUTP缺口末端标记 )技术检测肺细胞凋亡情况。结果 :与对照组 1比较 ,抑肽酶组的动静脉氧差较大 (2 0min时差异显著 ,P <0 .0 5 ) ,肺动脉压较低 (P <0 .0 5 )。电镜观察对照组 1肺结构破坏重。细胞凋亡检测显示对照组 1细胞凋亡数目高于抑肽酶组 (P =0 .0 0 18)和对照组 2 (P =0 .0 0 0 1) ,抑肽酶组细胞凋亡数目高于对照组 2 (P =0 .0 0 0 )。结论 :抑肽酶对于长期低温保存的兔肺有保护作用。细胞凋亡可作为评价肺移植后保护效果的指标之一。

Objective:To invesigate the protective effect of aprotinin on long-term hypothermic preserved rabbit lung.Method:Using a isolated blood-perfused ventilated rabbit lung model,15 rabbits were randomly divded to three goups (aprotinin group,control group 1,control group 2).Donor rabbits underwent lung harvest after Euro-Collins solution flush.The aprotonin group lungs underwent 24h of ischemic storage at 10℃ and reperfused with blood containing aprotinin (250,000KIU);the control group 1 lungs were stored for 24h and reperfused without aprotinin;control group 2 lungs were harvested from normal rabbit lung without storage and reperfusion.During reperfusion pulmoanry arterial-veinous oxygen difference?pulmonary artery pressure pressure were measured.After reperfusion,lung tissue were harvested for electron microscopic examination.The apoptotic cells were stained by the terminal deoxynucleotidyl transferase-mediated dUTP nick-end labeling (TUNEL) technique.Result:Compared with the control group1,the aprotinin group has higer pulmonary arterial-venous oxygen difference at 20 minutes after reperfusion started ( P <0.05).Electron microscopic examination revealed that the control group1 was more seirously damaged.The control group1 has more apoptosis pneumocytes than the aprotinin group (P=0.0018) and the control group (P=0.0001),aprontinin group has more apoptosis pneumocytes than the control group 1 (P=0.000).Conclusion:Aprotinin has protective effect on lung preservation,apoptosis unumber can be used as a index evaluating the pretective effect after lung transplantation.