联合应用维拉帕米和硝酸甘油对移植犬肺功能的影响

目的：观察在肺保护液中加入维拉帕米和硝酸甘油对移植犬肺功能的影响。方法：健康杂种犬20对，随 机分为4组，I组(对照组)采用低钾右旋糖酐液(LPD液)行供肺灌注保存，II组采用LPD液+维拉帕米(0.1 g/L)，III组采 用LPD液+硝酸甘油(0.1 g/L)，IV组采用LPD液+维拉帕米(0.1 g/L)+硝酸甘油(0.1 g/L)，每组5对，进行供受体左侧异体 单肺移植。观察肺移植术后0，2，4 h移植肺的血流动力学、气体交换功能，测量肺移植术后4 h移植肺组织的湿/干重 比、丙二醛含量、超氧化物歧化酶活性。结果：肺移植术后4 h，IV组的平均肺动脉压和肺血管阻力指数显著低于I， II，III组，IV组的氧分压和肺动态顺应性显著高于I，II，III组(P<0.05)，IV组的肺泡-动脉氧分压差显著低于I，II，III 组(P<0.05)，各组的二氧化碳分压和吸气压峰值差异无统计学意义(P>0.05)；IV组的移植肺湿/干重比低于I，II，III组 (P<0.05)，IV组的移植肺组织丙二醛含量显著低于I，II，III组(P<0.05)，超氧化物歧化酶活性IV组显著高于I，II，III 组(P<0.05)。结论：联合应用维拉帕米和硝酸甘油可以减轻移植犬肺水肿和氧化应激反应，改善供体肺功能。

Effect of verapamil and nitroglycerin on transplanted lung function in canines

Objective: To investigate the protective effect of combined administration of verapamil and nitroglycerin on the function of canine transplanted lungs. Methods: Twenty orthotopic left lung transplantations were performed in 40 canines, which were randomly divided into 4 groups. In group I (control), the donor lungs were perfused and preserved with LPD solution, while group II with LPD solution plus verapamil 0.1 g/L, group III with LPD solution plus nitroglycerin 0.1g/L, and group IV with LPD solution plus verapamil 0.1 g/L and nitroglycerin 0.1 g/L. Hemodynamics and graft gas exchange were assessed 0, 2 and 4 h after the operation. The lung grafts were harvested to measure the wet/dry weight ratio, malondialdehyde (MDA) contents and superoxide dismutase (SOD) activity. Results: Compared with group I, II and III, the mean pulmonary artery pressure (MPAP), pulmonary vascular resistance index (PVRI), partial pressure of oxygen in arterial blood (PaO2), dynamic compliance (Cdyn) and alveolar-arterial oxygen tension volume P(A- a)O2] in group IV were improved significantly (P<0.05). No significant difference in the partial pressure of carbondioxide (PaCO2) and peak inspiratory pressure (PIP) was observed in the 4 groups (P>0.05). In group IV, the wet/dry weight ratio and MDA contents were lower than those in the other 3 groups, and the SOD activity was significantly higher than that of the other 3 groups (P<0.05). Conclusion: Verapamil and nitroglycerin in LPD solution can protect the respiratory function of canine lung grafts by attenuating pulmonary edema and oxidative stress.