【摘要】：目的 觀察氧合血體外持續(xù)灌注保存和低溫靜態(tài)保存豬供肺對(duì)左肺移植后肺功能和炎癥因子的影響。方法 將用施爾生肺保護(hù)液(Celsior液)單次經(jīng)肺動(dòng)、靜脈灌洗后的廣西巴馬小型香豬供肺,分別經(jīng)氧合血體外持續(xù)灌注保存8h(實(shí)驗(yàn)組,n=6)和低溫靜態(tài)保存8h(對(duì)照組,n=6)后行左肺移植手術(shù),檢測(cè)再灌注0.5h、2h、4h、6h (IRO.5h、IR2h、IR4h、IR6h)左下肺靜脈氧合指數(shù)(Pa02/Fi02)和供肺保存前(T0)、供肺保存8h(T1)、再灌注3h(T2)和再灌注6h(T3)肺組織濕/干重(W/D),光鏡觀察肺組織病理結(jié)構(gòu)和肺組織中炎癥因子IL-1 β、IL-8和IL-10的濃度。結(jié)果 ①隨再灌注(IR)時(shí)間延長(zhǎng),兩組移植肺左下肺靜脈氧合指數(shù)均逐漸下降,W/D逐漸上升,但各時(shí)點(diǎn)實(shí)驗(yàn)組左下肺靜脈氧合指數(shù)均顯著高于對(duì)照組(P0.01)。對(duì)照組T1時(shí)點(diǎn)W/D明顯高于T0,且在T3時(shí)點(diǎn)明顯高于實(shí)驗(yàn)組(P0.05)。光鏡觀察T3時(shí)點(diǎn)對(duì)照組肺組織水腫分級(jí)比實(shí)驗(yàn)組高(P0.05)。②兩組肺組織IL-1β和IL-8濃度均呈上升趨勢(shì),但對(duì)照組增高更為明顯,在T3時(shí)點(diǎn)實(shí)驗(yàn)組與對(duì)照組比較,差異具有統(tǒng)計(jì)學(xué)意義(P0.05)。IL-1β在兩組中總體比較差異有顯著性(P0.05)。IL-8濃度在T1、T2和T3實(shí)驗(yàn)組均顯著低于對(duì)照組(P0.01),且在兩組中總體比較差異非常顯著(P0.01)。在T1時(shí)點(diǎn)觀察到兩組肺組織抗炎因子IL-10也表達(dá)上升,以抵御炎癥反應(yīng),但無(wú)統(tǒng)計(jì)學(xué)差異(P0.05)。結(jié)論 結(jié)果顯示供肺經(jīng)氧合血體外持續(xù)灌注保存移植入受體后,移植肺能獲得更為穩(wěn)定的氧合功能,肺水腫較輕,能維持較為完整的肺組織結(jié)構(gòu)。氧合血體外持續(xù)灌注保存可能在一定程度上抑制IL-1β和IL-8的釋放,從而起到減輕移植肺缺血再灌注損傷的作用。
[Abstract]:Objective to observe the effects of continuous perfusion preservation of oxygenated blood in vitro and cryogenic static preservation of pig donor lung on pulmonary function and inflammatory factors after left lung transplantation. Methods the donor lungs of Guangxi Bama miniature pigs were perfused with Celsior solution for 8 hours (experimental group, nong6) and control group (control group) respectively. The left pulmonary vein oxygenation index (Pa02/Fi02), left inferior pulmonary vein oxygenation index (Pa02/Fi02) and donor lung preservation (T0) were measured at 0.5 h, 2 h, 4 h and 6 h after reperfusion, respectively. The donor lung was preserved for 8 h (T1). Lung tissue wet / dry weight (W / D) was observed at 3 h (T 2) and 6 h (T 3) after reperfusion. The pathological structure of lung tissue and the concentrations of inflammatory factors IL-1 尾, IL-8 and IL-10 in lung tissue were observed under light microscope. Results 1 with the prolongation of reperfusion (IR), the oxygenation index of left inferior pulmonary vein in the two groups decreased gradually, and the W / D increased gradually, but the oxygenation index of left inferior pulmonary vein in the experimental group was significantly higher than that in the control group at each time point (P0.01). The W / D of control group was significantly higher than that of T0 at T1 and significantly higher than that of experimental group at T3 (P0.05). The histological grade of lung edema in T3 group was higher than that in experimental group (P0.05). 2 the concentrations of IL-1 尾 and IL-8 in lung tissue of both groups showed an upward trend, but the concentration of IL-1 尾 and IL-8 in control group was higher than that in control group, and at T3 time point, the concentration of IL-1 尾 and IL-8 in experimental group was higher than that in control group. The difference was statistically significant (P0.05). There was a significant difference in IL-1 尾 between the two groups (P0.05). The concentration of IL-8 in T2 and T3 groups was significantly lower than that in the control group (P0.01). There was a significant difference between the two groups (P0.01). At T1 time, the expression of anti-inflammatory factor IL-10 in lung tissue of two groups was also increased to resist inflammation, but there was no statistical difference (P0.05). Conclusion the results showed that the transplanted lung could obtain more stable oxygenation function, mild pulmonary edema, and maintain a complete lung tissue structure after continuous perfusion of donor lung oxygenated blood into the recipient in vitro. The continuous perfusion preservation of oxygenated blood in vitro may inhibit the release of IL-1 尾 and IL-8 to a certain extent, thus attenuating the ischemia-reperfusion injury of the transplanted lung.
【學(xué)位授予單位】：廣西醫(yī)科大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2016
【分類(lèi)號(hào)】：R614

【相似文獻(xiàn)】

相關(guān)期刊論文 前8條

1 王淑玲;郭玉巖;;ECMO研究進(jìn)展[J];內(nèi)蒙古中醫(yī)藥;2013年16期

2 李繼科;杜文娟;高宏;蔣樹(shù)林;田偉忱;;低溫氧合血+Celsior液微流量持續(xù)灌注對(duì)大鼠右心的保護(hù)效果[J];哈爾濱醫(yī)科大學(xué)學(xué)報(bào);2009年06期

3 孫玉華，秦元旭，馬香榮，席紅軍;體外循環(huán)中應(yīng)用常溫氧合血對(duì)心臟保護(hù)的觀察[J];新鄉(xiāng)醫(yī)學(xué)院學(xué)報(bào);1995年02期

4 于湘友;喬峻;鄭宏;鐘華;木拉提·瓦克力;任新英;馬松峰;霍強(qiáng);劉輝;;體外循環(huán)肺動(dòng)脈持續(xù)灌注含川芎嗪氧合血對(duì)肺損傷保護(hù)作用的研究[J];新疆醫(yī)科大學(xué)學(xué)報(bào);2006年09期

5 許玉華;紫外線照射氧合血治療妊娠期丹毒1例[J];陜西醫(yī)學(xué)雜志;1994年01期

6 高培顯;宋毅;谷興華;王濤;張希全;吳樹(shù)明;;肺動(dòng)脈灌注含腺苷的冷氧合血對(duì)體外循環(huán)術(shù)后肺損傷的臨床研究[J];山東大學(xué)學(xué)報(bào)(醫(yī)學(xué)版);2007年05期

7 王建明,王明海,陶曙光;氧合血肺動(dòng)脈灌注保護(hù)先天性心臟病病兒肺功能[J];中華胸心血管外科雜志;2005年05期

8 ;[J];;年期

相關(guān)會(huì)議論文 前1條

1 王振祥;段海云;吳莉莉;;微溫氧合血間斷灌注心肌保護(hù)在小嬰兒心內(nèi)直視手術(shù)中的應(yīng)用[A];第八屆華東六省一市胸心血管外科學(xué)術(shù)會(huì)議論文匯編[C];2005年

相關(guān)博士學(xué)位論文 前1條

1 于湘友;體外循環(huán)持續(xù)肺動(dòng)脈灌注含川芎嗪氧合血對(duì)肺保護(hù)作用的臨床研究[D];新疆醫(yī)科大學(xué);2006年

相關(guān)碩士學(xué)位論文 前4條

1 韓曉菲;常溫氧合血灌注保存豬供心的實(shí)驗(yàn)研究[D];河北醫(yī)科大學(xué);2015年

2 韋慧君;氧合血體外持續(xù)灌注保存對(duì)豬供肺功能和炎癥因子的影響[D];廣西醫(yī)科大學(xué);2016年

3 阿不拉江·賽達(dá)明;含甲潑尼龍氧合血肺動(dòng)脈持續(xù)灌注對(duì)體外循環(huán)肺損傷的臨床實(shí)驗(yàn)研究[D];新疆醫(yī)科大學(xué);2007年

4 高培顯;肺動(dòng)脈灌注含腺苷的低溫氧合血對(duì)體外循環(huán)術(shù)后肺損傷保護(hù)作用的臨床研究[D];山東大學(xué);2007年

，

本文編號(hào)：2315850