摘要
目的探讨一氧化氮(NO)前体L-精氨酸(L-Arg)在心肺移植中对心肺缺血再灌注损伤的保护作用。方法将30条成年犬随机分为对照组、实验A(L-Arg 100 mg／kg体重)、B(L-Arg 500 mg／kg体重)3组,每组10条,采用标准法行心肺移植,A、B组心肺保护液中加入不同剂量L-Arg,供心肺放入4℃EC液保存4-5 h。监测心率、平均动脉压(MAP)、肺动脉平均压(MPAP),股静脉血一氧化氮(NO)、超氧化物歧化酶(SOD)、丙二醛(MDA)、心肌肌钙蛋白I(cTnI)、乳酸脱氢酶同工酶 (LDH)含量、股动脉血氧分压(PaO2),测定肺干湿重比(W／DR)及观察心肺超微结构以评价心肺保护的效果。结果主动脉开放60 min,B组NO(82．76±12．34)μmol／L、A、B组SOD(60．19±12．42)、 (100．38±16．55)NU／ml较对照组(29．43±12．42)μmol/L、(26．65±5．68)NU／ml高(P<0．05),B组 cTnI(11．07±2．62)mg／L、MDA(2．48±0．51)nmol／ml、LDH(592．8±51．92)U／L较对照组(23．16± 2．76)mg／L、(4．48±0．54)nmol／ml、(719．80±292．16)U／L低(P<0．05),B组PaO2(207．60± 32．72)mmHg(1 mm Hg=0．133 kPa)高于对照组(130．20±13．36)mm Hg(P<0．05),A、B组W／DR (84．82±1．14)％、83．84±1．63)％小于对照组(88．44±1．42)％(P<0．05),电镜检查A、B组心肺损伤轻于对照组。结论供心肺可安全保存4-5 h,在心肺移植实验中加入L-Arg可使NO含量增加, 减轻心肺缺血再灌注损伤,B组(500 mg／kg体重)效果更好。
Objective To investigate the protective effect of L-arginine on ischemia-reprefusion ingury in heart-lung transplantation. Methods Thirty adult healthy dogs of both sexes were divided randomly into 3 groups： control group and treated groups A and B （each group having 10 dogs）. The hearts were flushed with Stanford solution and the lungs with Euro-Collins solution. In treated groups, different doses of L-arginine （100 mg/kg, group A; L-Arg 500 mg/kg, group B） were added to eardioplegie and lung perfusion solution. After 4-5 h preservation in 4 ℃ EC solution, the donor hearts-lungs were implanted into the recipient dogs. Hemodynamie parameters including heart rate, mean artery pressure （MAP）, mean pulmonary artery pressure （MPAP）, were recorded. NO, cTnI, SOD, MDA and LDH were determined in venous blood, and oxygen partial pressure in arterial blood. Lung wet/dry weight ratio （W/ DR） was measured and heart-lung aultrastructures were observed to evaulate the protective effects of heart-lung preservation. Results In 60 rain after aorta opening, the concentrations of NO （82.76 ± 12.34） μmol/L in group B and SOD [ （60.19 ± 12.42 NU/ml, （100.38 ± 16.55） NU/ml] in groups A and B were significantly higher than in the control group [ （29.43 ± 12.42） μmol/L and （26.65 ± 5.68） NU/ml, P 〈 0.05 ], while those of cTnI （ 11.07 ± 2.62 ） mg/L, MDA （2.48 ± 0.51 ） nmol/ml and LDH （592.80 ± 51.92） U/L were significantly lower in group B than in the control group （23.16 ± 2.76） mg/L, （4.48 ± 0.54） nmol/ml, （719.80 ± 292.16） U/L respectively, P 〈 0.05 ]. PaO2 was significantly higherin group B （207.60 ± 32.72） mm Hg （1 mm Hg = 0. 133 kPa） than in the control group （130.20 ± 13.36） mm Hg, P 〈 0.05. The W/DR in group A （84.82 ± 1.14） % and group B （83.84 ± 1.63） % was less than in the control group （88.44 ± 1.42） % （ P 〈 0.05）. Electron microscopy revealed that the injury of heart and lung in groups A and B was midler than in the control group. Conclusion The donor heart-lung could be preserved up to 4-5 h safely. Addition of L-arginine to eardioplegie and lung perfusion solution could increase the release of NO, alleviate the ischemia-reperfusion injury of heart and lung. The effects in group B （500 mg/kg body weight） were more satisfactory.
出处
《中华实验外科杂志》
CAS
CSCD
北大核心
2006年第4期573-575,共3页
Chinese Journal of Experimental Surgery
基金
广东省重点攻关项目(B30201)广东省卫生厅立项课题(A2002065)
关键词
L-精氨酸
心肺移植
再灌注损伤
L-arginine
Heart-lung transplantation
Reprefusion ingury
