治疗性高碳酸血症对肺移植缺血-再灌注损伤早期炎症因子的影响

王玲; 拉佈旦白拉

doi:10.3969/j.issn.1674-7445.2014.01.003

治疗性高碳酸血症对肺移植缺血-再灌注损伤早期炎症因子的影响

doi: 10.3969/j.issn.1674-7445.2014.01.003

王玲,
拉佈旦白拉^,

010050 呼和浩特, 内蒙古医科大学附属医院麻醉科

详细信息

通讯作者:
拉佈旦白拉,Email:labudan@163.com

中图分类号: R617
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- 被引次数: 0
出版历程
- 收稿日期: 2013-10-31
- 网络出版日期: 2021-01-19
- 刊出日期: 2014-01-15

Effect of therapeutic hypercapnia on the early inflammatory factors after ischemia-reperfusion injury of lung transplantation

Wang Ling,
La Budanbaila^,

Department of Anesthesiology, Affiliated Hospital of Inner Mongolia Medical University, Hohhot 010050, China

摘要

摘要: 目的研究治疗性高碳酸血症对肺移植缺血-再灌注早期炎症因子的影响。 方法 72只Wistar雄性大鼠,随机分为模型组(36只)和治疗组(36只)。两组基础状态给予50% N₂+50% O₂通气,模型组移植成功后给予50% N₂+50% O₂通气;治疗组移植成功后给予50% O₂、8%CO₂和42% N₂通气,维持动脉血二氧化碳分压(PaCO₂)在80~100 mmHg(10 mmHg=1.33 kPa)之间。记录受体大鼠机械通气1 min时MAP、PaCO₂和动脉血氧分压(PaO₂)作为基础值,再灌注期间每30 min记录1次,直至实验结束。分别于再灌注1、2、4 h取左肺下叶组织,采用酶联免疫吸附法测定肺组织中肿瘤坏死因子(TNF)-α和白细胞介素(IL)-1β的水平。结果与模型组比较,再灌注后各时间点治疗组受体鼠的MAP、PaO₂均明显升高(均为P<0.05)。与模型组比较,治疗组各时间点移植肺组织中TNF-α和IL-1β水平均有显著下降(均为P<0.05)。结论治疗性高碳酸血症对肺移植缺血-再灌注损伤后早期炎症因子的释放有抑制作用。
- 治疗性高碳酸血症 /
- 肺移植 /
- 缺血-再灌注损伤 /
- 炎症因子
Abstract: Objective To investigate the effect of therapeutic hypercapnia on the early inflammatory factors after ischemia-reperfusion of lung transplantation. Method Seventy-two male Wistar rats were randomly divided into model group (n=36) and therapy group (n=36). Rats on the baseline in model group and therapy group were ventilated with 50% N₂ and 50% O₂. Rats in model group were continuously ventilated with 50% N₂ and 50% O₂ after successful transplantation. Rats in therapy group were ventilated with mixed gases after successful transplantation, which included 50% O₂, 8% CO₂, and 42% N₂ to keep arterial partial pressure of carbon dioxide(PaCO₂) in the range of 80~100 mmHg(10 mmHg=1.33 kPa). The mean arterial pressure (MAP)、PaCO₂ and arterial partial pressure of oxygen (PaO₂) of recipient rats were recorded as baseline value after mechanical ventilation for 1 minute. Then the data were recorded once every 30 minutes during reperfusion period until the end. The inferior lobes of left lung sample were taken at 1, 2,4 h after reperfusion respectively. The levels of tumor necrosis factor(TNF)-α and interleukin(IL)-1β in lung tissues were measured by enzyme-linked immunosorbent assay. Result Compared with model group, MAP and PaO₂ were significantly higher in therapy group at different time points after reperfusion (all in P<0.05). Compared with model group, the levels of TNF-α and IL-1β of transplant lung tissues were significantly lower in therapy group at different time points after reperfusion(all in P<0.05). Conclusion The therapeutic hypercapnia plays an inhibitive role on the release of early inflammatory factors after the ischemia-reperfusion injury of lung transplantation.
- Therapeutic hypercapnia /
- Lung transplantation /
- Ischemia-reperfusion injury /
- Inflammatory factor

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表 1 两组受体鼠再灌注后不同时间点平均动脉压与血气分析结果的比较

Table 1. Comparison of mean arterial pressure and arterial blood gas analysis of recipient rats between two groups at different time points after reperfusion (mmHg，x±s)

项目	n	基础值	再灌注
项目	n	基础值	30 min	60 min	90 min	120 min	150 min	180 min	210 min	240 min
MAP
治疗组模型组	1212	110±10115±8	112±8^b95±10^a	113±12^b97±8^a	118±10^b100±7^a	117±12^b102±11^a	114±12^b106±12^a	112±10^b103±13^a	114±12^b100±11^a	112±14^b99±11^a
PaO₂
治疗组模型组	1212	234±19231±15	218±36^b185±30^a	225±30^b186±26^a	232±32^b183±30^a	240±38^b178±38^a	242±33^b176±40^a	245±32^b174±42^a	241±35^b170±36^a	247±31^b168±42^a
PaCO₂
治疗组模型组	1212	31±434±3	82±5^a，b37±4	84±7^a，b39±5	90±8^a，b42±6	87±5^a，b40±5	89±8^a，b44±3	88±6^a，b46±4	85±5^a，b43±4	82±7^a，b42±5
注：与同组基础值比较，^aP＜0.05；与模型组比较，^bP＜0.05

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表 2 两组受体鼠再灌注后移植肺组织炎症因子的比较

Table 2. Comparison of inflammatory factors of transplant lung tissues of recipient rats between two groups after reperfusion (μg/L，x±s)

组别	n	TNF-α			IL-1β
组别	n	再灌注1 h	再灌注2 h	再灌注4 h	再灌注1 h	再灌注2 h	再灌注4 h
治疗组	12	0.50±0.11^a	0.62±0.06^a	0.77±0.14^a	0.28±0.03^a	0.33±0.06^a	0.31±0.05^a
模型组	12	0.76±0.05	0.82±0.05	0.89±0.16	0.32±0.05	0.37±0.05	0.33±0.07
注：与模型组比较，^aP＜0.05

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