外源性一氧化碳改善供体肺功能的实验研究

目的观察一氧化碳(CO)对长时间低温保存的供体肺的保护作用。方法建立大鼠肺移植离体肺灌注实验模型:SD大鼠24只随机分为空白对照组、实验组(CO组),每组6对作为肺移植的供体鼠和受体鼠。对照组大鼠供肺移植全程吸入100%氧气直至再灌注后1h;CO组移植全程吸入500×10-6CO和O2的混合气,并且供体肺在冷保存的12h内肺内仍充盈着CO和O2的混合气,余同对照组。于供体肺循环灌注l,20,40,60min测定供肺氧合后动脉血氧分压(PaO2)、平均肺动脉压、气道峰压;灌注结束后测定肺组织湿干比、丙二醛(MDA)含量、髓过氧化物酶(MPO)活性、白细胞介素8(IL-8)的含量。结果作为受体的12只(每组6只)进入结果分析:①CO组供体肺的PaO2在再灌注20、40、60min明显高于对照组,平均动脉压、气道峰压分别在再灌注20、40、60min和40、60min明显低于对照组(P<0.05);②与空白对照组比较,CO组供体肺再灌注后湿干比、MDA、MPO、IL-8含量均明显降低(P<0.05)。结论在肺移植的全程吸入低剂量CO可以减轻供肺的缺血再灌注损伤,改善供肺功能。

Experimental Research on Protective Effect of Exogenous Carbon Monoxide with Low Dose Inhalation on Donor Lung of Rats

Objective To investigate the protective effect of exogenous carbon monoxide with low dose inhalation on donor lung of rats after long time cold ischemic preservation. Methods After the isolated lung transplantation and reperfusion model in rats established, 24 rats were randomly divided into blank control group and CO group, with 6 pairs for each served as donor and recipient rats of lung transplantation. In control group (n=6), donor lungs were stored in pure oxygen and then reperfused. In CO group (n=6), donor lungs were filled with low dose carbon monoxide during the whole transplantation procedure. Arterial pressure of oxygen (PaO2), mean pulmonary artery pressure (mPAP), peak airway pressure (PAP) were measured at 1, 20, 40, 60 minutes during reperfusion. The wet-to-dry (W/D) ratio, malondiadehyde (MDA), myeloperoxidase (MPO) activity and interleukin-8 (IL-8) were obtained after reperfusion. Results Six recipient rats in each group entered the result analysis. (1) Compared with control group, PaO2 of 20, 40, 60 minutes was significantly higher, mPAP of 20, 40, 60 minutes and PAP of 40, 60 minutes was obviously lower respectively in CO group during reperfusion (P<0.05). (2)After reperfusion, the W/D ratio, MDA, MPO and IL-8 of CO group were respectively lower than that of control group (P<0.05). Conclusion Exogenous low dose carbon monoxide inhalation on donor lung of rats can effectively improve the respiratory function by attenuating lung ischemic-reperfusion injury.