大鼠自体原位肝移植逆灌注法对急性肺损伤的影响

目的探讨大鼠自体原位肝移植术中经下腔静脉逆灌注与经门静脉顺灌注法对急性肺损伤的影响。方法SD大鼠24只随机分成逆灌注组、顺灌注组、假手术组，分别建立大鼠自体原位肝移植逆灌注、顺灌注和假手术模型，检测3组术后6h腹主动脉血气、肺髓过氧化物酶活性、肺干湿重比值及肺组织病理形态学变化。结果与假手术组比较，逆灌注组、顺灌注组的动脉血pH值、PaO2、肺干湿重比值明显降低，肺髓过氧化物酶活性显著增高，差异均有统计学意义（P〈0．05）。与顺灌注组比较，逆灌注组动脉血pH值、PaO2、肺干湿重比值升高，肺髓过氧化物酶活性降低，差异有统计学意义（P〈0．05）。逆灌注组、顺灌注组术后肺组织均存在急性损伤病理表现，逆灌注组损伤程度有所减轻。结论大鼠自体原位肝移植逆灌注法、顺灌注法后均存在急性肺损伤，逆灌注法较顺灌注法损伤程度要轻。

Effect on acute lung injury in rats after retrograde reperfusion in autologous liver transplantation

Objective To explore the effect on acute lung injury in rats after the inferior vena cava retrograde perfusion and via the portal vein perfusion in autologous liver transplantation. Methods Twenty-four SD rats were randomly divided into three groups: retrograde perfusion group, perfusion group and control group. Six hours after the models were established, the value of pH and PaO2 in artery blood, the concentration of myelopercxidase in lung tissue and lung dry-to-wet weight radio were measured. Furthermore, the lung pathological section were observed. Results Compared to control group, the value of pH, P_aO₂ and the ratio of lung dry-to-wet weight were lower were lower, the concentration of myelopercxidase were higher in retrograde perfusion group and perfusion group, the difference were statistically significant （P < 0.05）. Compared with perfusion group, the value of pH, P_aO₂ and the ratio of lung dry-to-wet weight were lower were higher, the concentration of myelopercxidase were lower in retrograde perfusion group, the difference were statistically significant （P < 0.05）. And pathological examination showed the lung damaged were less sever in retrograde perfusion group. Conclusions Retrograde perfusion and perfusion in autologous liver transplantation both cause acute lung injury in rats, the extent of injury induced by retrograde perfusion is lesser than that by perfusion.