氧合血体外持续灌注保存对猪供肺功能和炎症因子的影响

发布时间：2018-11-07 09:00

【摘要】：目的观察氧合血体外持续灌注保存和低温静态保存猪供肺对左肺移植后肺功能和炎症因子的影响。方法将用施尔生肺保护液(Celsior液)单次经肺动、静脉灌洗后的广西巴马小型香猪供肺,分别经氧合血体外持续灌注保存8h(实验组,n=6)和低温静态保存8h(对照组,n=6)后行左肺移植手术,检测再灌注0.5h、2h、4h、6h (IRO.5h、IR2h、IR4h、IR6h)左下肺静脉氧合指数(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)肺组织湿/干重(W/D),光镜观察肺组织病理结构和肺组织中炎症因子IL-1 β、IL-8和IL-10的浓度。结果 ①随再灌注(IR)时间延长,两组移植肺左下肺静脉氧合指数均逐渐下降,W/D逐渐上升,但各时点实验组左下肺静脉氧合指数均显著高于对照组(P0.01)。对照组T1时点W/D明显高于T0,且在T3时点明显高于实验组(P0.05)。光镜观察T3时点对照组肺组织水肿分级比实验组高(P0.05)。②两组肺组织IL-1β和IL-8浓度均呈上升趋势,但对照组增高更为明显,在T3时点实验组与对照组比较,差异具有统计学意义(P0.05)。IL-1β在两组中总体比较差异有显著性(P0.05)。IL-8浓度在T1、T2和T3实验组均显著低于对照组(P0.01),且在两组中总体比较差异非常显著(P0.01)。在T1时点观察到两组肺组织抗炎因子IL-10也表达上升,以抵御炎症反应,但无统计学差异(P0.05)。结论结果显示供肺经氧合血体外持续灌注保存移植入受体后,移植肺能获得更为稳定的氧合功能,肺水肿较轻,能维持较为完整的肺组织结构。氧合血体外持续灌注保存可能在一定程度上抑制IL-1β和IL-8的释放,从而起到减轻移植肺缺血再灌注损伤的作用。
[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.
【学位授予单位】：广西医科大学
【学位级别】：硕士
【学位授予年份】：2016
【分类号】：R614

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