吸入一氧化氮对兔缺血-再灌注肺血流动力学和气体交换影响的实验研究.docVIP

???? 吸入一氧化氮对兔缺血-再灌注肺血流动力学和气体交换影响的实验研究 ???? ????????关键词：一氧化氮；再灌注；肺；血流动力学????中国病理生理杂志000315????[摘 要] 目的：评价吸入一氧化氮(NO)对缺血-再灌注兔肺血流动力学和气体交换的影响。方法：40只健康新西兰大白兔随机分成4组，每组10只。Ⅰ假手术组；Ⅱ假手术+吸入NO；Ⅲ缺血-再灌注组；Ⅳ缺血-再灌注+吸入NO组。Ⅱ、Ⅳ组吸入NO 50×10-6。再灌注240 min连续动态观察肺动脉压(PA)、肺血管阻力(PVR)、氧分压(PaO2)、二氧化碳分压(PaCO2)、肺泡动脉血氧差(A-aDO2)、肺内动静脉分流(Qs/Qt)、外周白细胞数、CD18的表达、高铁血红蛋白。结果：(1)吸入NO不影响正常兔肺血流动力学和气体交换功能。(2)肺再灌注时早期吸入NO后PaO2上升，PA、PVR、PaCO2、A-aDO2、Qs/Qt下降，CD18的表达及外周白细胞数无明显变化。(3)吸入NO对高铁血红蛋白的升高无明显影响。结论：吸入NO能明显改善再灌注肺早期血流动力学和气体交换功能。????[中分类号] R 322.3+5 [文献标识码] A????[文章编号] 1000-4718(2000)03-0247-05????Effect of inhaled nitric oxide on the gas exchange and hemodynamic of ischemia-reperfusion lung in rabbit model????CAO Hua, LIAO Chong-xian, CHEN Dao-zhong????Dept of Cardiovascular Surgery, Union Hospital, Fujian Medical University, Fuzhou 350001, China)????[Abstract] AIM:To evaluate the effect of pulmonary gas exchang and hemodynamic by inhaled nitric oxide on ischemia-reperfusion(I/R) lung in rabbit model.METHODS:Forty Newzealand rabbits were divided into four groups: group Ⅰ, sham-operated; group Ⅱ, sham-operated with inhaled nitric oxide (NO); group Ⅲ, I/R; group Ⅳ, I/R with Inhaled NO. Pulmonary artery pressure (PA), pulmonary vascular resistance(PVR), arterial oxygen tension(PaO2), arterial carbon dioxide tension (PaCO2), alveolar-arterial gradient (A-aDO2), Shunt fraction (Qs/Qt) expression of CD18, peripheral leukocyte, methemoglobin were continuetly quantitated. RESULTS:At the start of reperfusion inhaled NO significantly improved PaO2 and decreased PA, PVR,PaCO2,A-aDO2,Qs/Qt.CONCLUSION:Inhaled NO ameliorated significantly the early gas exchange and hemodynamic of reperfusion lung.????[MeSH] Nitric oxide; Reperfusion; Lung; Hemodynamics????在心胸外科领域，肺移植、心肺联合移植、体外循环及主动脉手术后常出现难以预测的早期肺功能不全，甚至呼吸窘迫综合征等并发症。其主要原因与肺再灌注损伤有关。肺再灌注早期内皮细胞功能障碍，氧自由基的产生，一氧化氮(nitric oxide,NO)的合成和分泌减少及粘附分子、特别是CD18的表达增强，大量的白细胞在肺内“扣押”等一系列病理生理反应，导致了肺功能不全。但吸入NO对肺再灌注损伤的研究刚刚起步，争议较多，国内尚未见报道。本研究旨在观察兔缺血-再灌注早期吸入50×10-6NO对肺血流动力学和气体交换的影