本文選題：左西孟旦 + 體外循環(huán)��； 參考：《安徽醫(yī)科大學》2015年碩士論文

【摘要】：背景:體外循環(huán)(CPB,cardiopulmonary bypass)技術(shù)的發(fā)展在心臟外科中具有里程碑的意義,使得心內(nèi)直視技術(shù)得以開展,但同時CPB術(shù)后的并發(fā)癥嚴重影響了術(shù)后患者的臨床轉(zhuǎn)歸,尤其是CPB術(shù)后急性肺損傷(ALI,actue lung injury),增加了術(shù)后的并發(fā)癥延長了ICU住院時間,增加了術(shù)后死亡率。CPB術(shù)后ALI機制目前尚未明確,但可能與CPB術(shù)后全身炎癥反應(SIRS,systemic inflammatory response syndrome),缺血灌注損傷(I/R,ischemia-reperfusion injury)、細胞凋亡、機械物理因素的損傷等多種因素有關(guān),左西孟旦(LS,Levosimendan)作為新一代鈣增敏劑,于2000年首次在瑞典上市,其具有明顯提高心肌收縮力的作用,而且還不增加細胞耗氧,臨床上已用該藥治療各種急性心力衰竭等病癥。LS還具有明顯抗缺血再灌注損傷、抗細胞凋亡及減少炎癥因子產(chǎn)生的作用,有學者證明LS還具有臟器保護作用。目的:探索左西孟旦(LS)對實驗用雜種犬體外循環(huán)(CPB)術(shù)后急性肺損傷(ALI)是否具有保護作用。方法:實驗用雜種犬32只,隨機分為4組,對照組(C組),氧和冷血肺動脈灌注組(P組),LS靜脈注射組(LSIV);含LS的氧和冷血肺動脈灌注組(LSP組),LS的劑量均為65 g/kg;檢測各組肺組織中丙二醛(MDA)含量、超氧化物歧化酶(SOD)活性,光鏡及電鏡觀察肺組織的病理形態(tài)學變化。結(jié)果:肺組織中MDA含量及SOD活性,與C組相比,LSP組、P組及LSIV組MDA含量明顯降低,且SOD活性明顯升高(P0.05),與LSP組相比,LSIV組及P組MDA含量明顯升高,且SOD活性明顯降低(P0.05),P組和LSIV組無統(tǒng)計學意義(P0.05)。結(jié)論:通過犬動物實驗模型,單純肺動脈灌注、肺動脈灌注及靜脈注射LS,MDA含量明顯減少,SOD活性增高,對肺組織具有保護作用。
[Abstract]:Background: the development of cardiopulmonary bypass (CPB) is a milestone in cardiac surgery, which makes the open heart vision technology develop. However, the complications after CPB seriously affect the clinical outcome of the patients. Especially, the mechanism of acute lung injury after CPB is not clear, which increases the postoperative complications and prolongs the hospitalization time of ICU, and increases the postoperative mortality. CPB.The mechanism of ALI after operation is not clear. But it may be related to many factors, such as systemic inflammatory response after CPB, I / R / reperfusion injury, apoptosis, injury of mechanical and physical factors, etc., as a new generation of calcium sensitizer, Levosimendan, a new type of calcium sensitizer, was first listed in Sweden in 2000. It can obviously improve myocardial contractility, and does not increase cell oxygen consumption. It has been used to treat all kinds of acute heart failure. LS also has obvious anti-ischemia-reperfusion injury. Anti-apoptosis and reducing the production of inflammatory factors, some scholars prove that LS also has organ protection. Aim: to investigate the protective effect of LSs on acute lung injury (ALI) after CPB in experimental mongrel dogs. Methods: Thirty-two mongrel dogs were randomly divided into 4 groups. Control group C, oxygen and cold blood pulmonary artery perfusion group P group LSIVD, LS-containing oxygen group and cold blood pulmonary artery perfusion group LSP dose were 65 g / kg, the content of malondialdehyde (MDA) MDAs and the activity of superoxide dismutase (SOD) in lung tissue of each group were measured. The histopathological changes of lung tissue were observed by light microscope and electron microscope. Results: compared with group C, the content of MDA and the activity of SOD in lung tissue decreased significantly in group P and group LSIV, and the activity of SOD increased significantly (P 0.05), and the content of MDA in group C and group P was significantly higher than that in group LSP. Moreover, the activity of SOD was significantly decreased in P 0.05 P group and LSIV group, and there was no significant difference between P 0.05 group and LSIV group. Conclusion: in canine animal model, pulmonary artery perfusion, pulmonary artery perfusion and intravenous injection of LSMDA can significantly reduce the increase of SOD activity and have protective effect on lung tissue.
【學位授予單位】：安徽醫(yī)科大學
【學位級別】：碩士
【學位授予年份】：2015
【分類號】：R654.1
，

本文編號：1846778