發(fā)布時(shí)間：2021-11-05 09:50

　　肺缺血再灌注導(dǎo)致的損傷常見于外科臨床,尤以應(yīng)用體外循環(huán)（CPB）技術(shù)的各類手術(shù)及肺移植術(shù)后最為突出。術(shù)后肺功能障礙對(duì)患者的預(yù)后有著不容低估的影響,成為影響CPB術(shù)后恢復(fù)的非心血管并發(fā)癥的首要因素。尤其是在嬰幼兒先心病手術(shù)后,此類損傷已成為直接影響術(shù)后轉(zhuǎn)歸的最主要因素。對(duì)其發(fā)生機(jī)制的研究和尋求有效的防治措施是近年來國(guó)內(nèi)外心血管外科共同關(guān)注的重要課題。研究者們致力于采用各種手段（如白細(xì)胞濾過、缺血預(yù)適應(yīng)等）及藥物干預(yù)（如糖皮質(zhì)激素、氧自由基清除劑、蛋白酶抑制劑以及中藥等）來預(yù)防或減輕肺缺血再灌注損傷,雖取得一定的效果,但這些方法對(duì)嬰幼兒未成熟肺損傷的保護(hù)作用并不顯著,相關(guān)方面的研究亦少見報(bào)道。因此,有必要對(duì)此類急性肺損傷病理生理過程進(jìn)行再認(rèn)識(shí);積極探索未成熟肺損傷的特點(diǎn);尋求進(jìn)一步的、針對(duì)性的保護(hù)方法;以此達(dá)到改善嬰幼兒體外循環(huán)術(shù)后肺功能及患者預(yù)后的目的;從而提高應(yīng)用體外循環(huán)技術(shù)各類手術(shù)效果,特別是對(duì)嬰幼兒先心病手術(shù)治療水平具有重大意義和臨床應(yīng)用價(jià)值。據(jù)文獻(xiàn)報(bào)道,在大量前炎性細(xì)胞因子TNF-α、IL-1β及ROS等通過炎性細(xì)胞表面TOLL受體將刺激信號(hào)傳遞到胞漿后,髓核細(xì)胞分化因子MyD8... 

【文章來源】：南京醫(yī)科大學(xué)江蘇省

【文章頁(yè)數(shù)】：167 頁(yè)

【學(xué)位級(jí)別】：博士

【文章目錄】：
1.Abbreviations
2.Abstracts
    1)Abstract in Chinese
    2)Abstract in English
3.Introduction
    1)Ischemia-reperfusion(IR)and acute lung injury(ALI)in cardiothoracic surgery
    2)Animal models of lung IR injury(LIRI)
    3)The mechanisms of IR-induced lung injury in general
    4)The mechanisms of IR-induced lung injury in infants
    5)Current preventions and treatments of lung IR injury
    6)A new drug--Edaravone
4.Aims of the study
    1)Principal objectives
    2)Specific aims
5.Part Ⅰ
    1)Purpose
    2)Materials and methods
    3)Results
    4)Discussion
        ① Infant vs adult lung damage at light microscopic level
        ② Infant vs adult lung damage at electron microscopic level
        ③ Infant vs adult lung mitochondrial damage
        ④ Oxidative stress in infants vs adults
        ⑤ TNF-α,IL-1β,NF-κB and MyD88 in infants vs adults
6.Part Ⅱ
    1)Purpose
    2)Materials and methods
    3)Results
    4)Discussion
        ① ROS is one of the most important mediator of IR injury
        ② The choose of free radical scavenger-Edaravone
        ③ Dosing and timing of Edaravone
        ④ Therapeutic effects of Edaravone
7.Conclusions
8.Future studies and perspectives
    1.Molecular mechanism underlying IR-induced lung injury
    2.Prevention and treatment of IR-induced lung injury
9.References
10.Acknowledgements
11.List of publications
12.Appendix
    1)Papers
    2)Meetings



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