自体原位肝移植大鼠围术期急性肺损伤的研究

目的 建立SD大鼠自体原位肝移植模型,动态观察自体原位肝移植围术期肺损伤特点.方法 选取健康SPF级SD大鼠40只,随机分为假手术对照组(S组,n=8)和模型组(M组),M组进行自体原位肝移植手术,根据肝脏再灌注时间不同再分为4个亚组.S组在麻醉后只进行开腹和血管的分离,不进行肝脏的阻断和灌注.分别在肝脏再灌注后4、8、16、24 h采集动脉血和肺组织标本,分别用于检测动脉氧分压、肺组织病理学.结果 与S组(120.75 ±6.58) mm Hg(1 mmHg =0.133 kPa)]比较,M2组(97.50±8.22)mm Hg动脉氧分压降低(P＜0.05),其余各组差异无统计学意义(P＞0.05).M组肺组织镜下见大量的炎症细胞浸润,肺泡腔内渗出明显,肺泡腔狭窄,肺间质明显出血充血,肺泡间隔明显增厚,肺实质所占的比例显著增加；这些病理改变在M2组(肝脏再灌注8h)达到高峰,然后逐渐好转.结论 自体原位肝移植后SD大鼠存在肺损伤,在肝脏再灌注后8h达到高峰.

Acute lung injury after orthotopic liver autotransplantation in SD rat model

Objective To investigate characteristics and regularity of lung injury after orthotopic liver autotransplantation in the SD rat model.Methods Forty Sprague-Dawley rats were randomly divided into sham operated group(Group S,n =8) and model group( Group M).According to the time of liver reperfusion,the rats in Group M were divided into 4 h after reperfusion(Group M1,n=8),8 h after reperfusion ( Group M2,n =8),16 h after reperfusion ( Group M3,n =8 ),24 h after reperfusion ( Group M4,n =8).The rats in 4 model groups were anesthetized after reperfusion for 4 h,8 h,16 h,and 24 h respectively,and then collected the artery blood and lung tissue for the detection of PaO2 and morphologic changes of pulmonary pathology.Results Compared to Group S,there was a significant decrease of PaO2in GroupM2 (120.75 ±6.58) mm Hg (1 mm Hg=0.133 kPa) vs.(97.50 ±8.22) mm Hg,P＜0.05 ],while there were no significant among Group S,M1,M3 and M4 ( P ＞ 0.05 ).Light microscope showed that plenty of inflammatory cells infiltration,the obvious exudate in narrow alveolar space,the significant bleeding and hyperemia in pulmonary intersitital tissue,the thickening of alveolar interval,and much more lung parenchyma in the model groups,which was most significant in Group M2,and then improved gradually.Conclusion There existed lung injury after orthotopic liver autotransplantation for rats and showed most significanly at reperfusion for 8 h.