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L-精氨酸在离体肺保存中的作用

摘要

Objective: This study was to investigate the protective effect of L-arginine infusion on lung preservation in a isolated-lung reperfusion model. Methods: 14 New Zealand white rabbits were randomly divided into two groups. In the control group, the lungs were flushed and preserved with modified Euro-Collins solution(ECS) while in the treated group, 3?mmol/L L-Argninine were added to Euro-ccollins solution. The harvested blocks were preserved at 4℃ for 6 hours and reperfused with whole blood for pulmonary functional assessment. The protective effects was assessed by measuring partial oxygen tension of pulmonary venous effluent blood, the content of nitric oxide(NO), superoxide dismutase (SOD) and lipid peroxide (LPO) in the blood and the lung tissues, and the ultrastructural studies of lung. Results: The PpvO2 at 5 min after reperfusion was significantly higher in the treated group than in the control group. The concentration of NO and SOD in the pulmonary venous blood and the lung tissue was significanlty higher in the treated group than in the control group, however, the change of LPO was adverse. Transmission electron microscopic examination showed the lesions in the treated group was milder than in the control group. Conclusion: The protective effects of L-Arginine in conjunction with modified ECS flush and storage were surperior. It can attenuate the lung injury by cold preservation, ischemia, and ischemia-reperfusion during the 6 hours lung preservation.%目的研究一氧化氮前体L-精氨酸(L-Arg)在离体兔肺保存中的保护作用。方法将14只新西兰兔随机分为2组,对照组以改良的Euro-Collins(ECS)液灌注及保存供肺,实验组以L-精氨酸(3?mmol/L)加入改良的ECS液中灌注及保存供肺。冷保存6?h。以自体血再灌注1?h后,做肺静脉血气分析(PvO2),并测定血及肺组织中一氧化氮(NO)、超氧化物歧化酶(SOD)、脂质过氧化物(LPO)含量及肺组织的超微结构以评价肺保护的效果。结果再灌注后,实验组比对照组血氧分压显著提高(P<0.05)。实验组血及肺组织中NO及SOD含量较对照组高(P<0.05),LPO含量较对照组低(P<0.05)。透射电镜检查实验组损伤轻于对照组。结论肺保存不超过6?h时,在改良的ECS液中加入L-Arg用于离体肺的灌注和保存,能减轻肺损伤。

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