低温体外循环不阻断升主动脉室颤左室引流对犬肺组织保护作用的实验研究-外科学专业论文.docx

中文摘要 的积分光密度值比 CPB 前显著增高(P0.05),但对照组肺组织的 NF- B 及 ICAM-1 的积分光密度值显著高于实验组(P0.05) 结论 1.主动脉阻断时间ACCT对术后炎性反应的程度有明显影响 CPB 后血清 IL-8 与 ACCT 呈显著正相关 2.体外循环引起的炎性反应对肺功能的影响表现在肺顺应性在体 外循环过程中显著下降 血清 IL-8 的浓度与相应时间点的肺顺应性成 显著负相关 说明体外循环引起的肺功能受损 损伤程度与炎性细胞 因子的变化有关 3.体外循环可以引起全身性炎症反应 表现为血清 IL-8 浓度的明显 升高 体外循环引起的全身炎性反应 激活核因子- B 这一细胞应激 反应的分子 活化的 NF- B 能使 IL-8 ICAM-1 等过度表达 使中性 粒细胞与肺血管内皮细胞发生黏附 从而使肺组织发生炎性损害 4. 低温体外循环不阻断升主动脉室颤左室引流术在一定程度上减 轻了心肌缺血再灌注损伤,降低了围术期 IL-8 等炎性因子的物质的含 量,减轻了 CPB 引起的全身炎症反应,从而抑制了 NF- B 的激活,减少 促炎基因的表达,可降低组织的损伤和炎症反应程度,对心肺功能有一 定的保护作用 关键词: 体外循环 全身炎性反应综合症 肺损伤 低温室颤 核 因子- B 细胞间黏附分子 血清白介素-8 肺顺应性 2 英文摘要 英文摘要 PAGE 3 Experimental Research of Hypothermic Ventricular Fibrillation with Left Ventricular Drainage under Cardiopulmonary Bypass on Canine Lung Preservation without Aortic-cross Clamping Abstract Objective:To evaluate the protective effect of hypothermic ventricular fibrillation without aortic-cross clamping under cardiopulmonary bypass on canine lung Methods:Fourteen dogs were randomly divided into two groups(n=7):hypothermic fibrillatory arrest group(experimental group) and cold crystalloid cardioplegia group(control group).All dogs received a standardized anesthetic technique.In every instance,the operation was performed via the fourth right intercostal.A standardied CPB was performed in the control group.Ventricular fibrillatory was induced with systemic hypothermia to 28 and pericardial cooling with 4 saline in the experimental group . The concentration of serum IL-8 and lung compliance were measured before CPB at the 2nd hours during CPB at the end of CPB and at the 1st hours after CPB. Atrial lung specimens were abtained at two time points:before CPB and at the end of CPB. Lung morphological damage was observed under light microscope at the above-mentioned time points.A study on the expressions of NF- B and ICAM-1 on canine lung tissue were made by using immunohistochemical staining method at the same time points.To assess the effect of hypothermic ventricular