体外循环中低温保护液肺动脉灌注的肺血管内皮保护作用

目的探讨体外循环(CPB)期间低温改良低钾右旋糖酐(LPD)溶液肺动脉灌注对CPB中肺血管内皮细胞损伤的保护作用。方法30例行二尖瓣置换术病人随机分成肺灌注组15例,对照组15例。肺灌注组病人CPB术中一次性肺动脉灌注低温改良LPD液,对照组常规行二尖瓣置换术,未行肺动脉灌注。于CPB结束30min,取右上肺小块肺组织作冰冻切片免疫组化检测肺血管内皮细胞粘附分子(ICAM-1)、皮源型一氧化氮合酶(eNOS)、诱生型一氧化氮合酶(iNOS)的表达。结果肺灌注组ICAM-1、iNOS表达明显弱于对照组(P<0.05),肺灌注组eNOS表达明显强于对照组(P<0.05)。结论CPB中低温改良LPD液肺动脉灌注对CPB中肺血管内皮损伤有保护作用。

Effect of Pulmonary Artery Perfusion with Modified LPD Solution on Pulmonary Vascular Endothelial Cell Injury During Cardiopulmonary Bypass

Objective To test the effect of pulmonary artery perfusion with modified low-potassium dextran(LPD) solution on lung vascular endothelial cell injury during cardiopulmonary bypass(CPB). Methods Thirty patients undergoing mitral valve replacement were randomly divided into the control group (n=15) and the lung perfusion group (n=15). The patients in the lung perfusion group were perfused with modified LPD solution into the pulmonary artery during CPB. The control group performed with the routine solution during CPB mitral valve replacement. Lung biopsy specimens were obtained at 30min after CPB. The expression of ICAM-1,eNOS and iNOS were measured by immunohistochemical technique. Results The expression of ICAM-1 and iNOS in lung perfusion group was lower than that in the control group, while the expression of eNOS in lung perfusion group was higher than that in the control group (P<0.05). Conclusion Pulmonary artery perfusion with modified LPD solution during CPB demonstrates the protective effect on lung vascular endothelial cell.