Soncul H, Oz E, Kalaycioglu S
Department of Thoracic and Cardiovascular Surgery, Gazi University Medical Faculty, Ankara, Turkey.
Chest. 1999 Jun;115(6):1672-7. doi: 10.1378/chest.115.6.1672.
Ischemia-reperfusion injury of the lung frequently occurs after cardiopulmonary bypass, after pulmonary thromboembolectomy, and especially during lung transplantation. The protective effects of preconditioning on the heart, liver, bones, and various other organs have been previously evaluated. In this comparative study, we used isolated guinea pig lungs to show the effects of preconditioning on lung ischemia.
The lungs (n = 10 in each group) were mounted on a modified Langendorff perfusion apparatus and perfused by Krebs-Henseleit solution for 30 min. We applied an ischemic preconditioning (5 min ischemia + 5 min perfusion, two times) in the experimental group. After 3 h of normothermic ischemia, the lungs were reperfused for 30 min. Pulmonary artery pressures and malondialdehyde (MDA) and glutathione (GSH) levels of the tissue and the perfusate were measured before and after the ischemic period and also at the end of reperfusion. Electron microscopic evaluation was done on randomly selected lungs of three animals in each group at the end of the experiment.
Both MDA and GSH levels of tissue and perfusate decreased in the experimental group after reperfusion, although the reduction in GSH levels did not reach statistical significance. The increase in pulmonary artery pressure was lower in the preconditioning group after reperfusion.
Our data showed that ischemic preconditioning of the lung may have a protective effect in ischemic-reperfusion injury.
肺缺血再灌注损伤常见于体外循环后、肺血栓栓子切除术后，尤其是在肺移植过程中。预处理对心脏、肝脏、骨骼及其他多种器官的保护作用此前已得到评估。在这项比较研究中，我们使用离体豚鼠肺脏来展示预处理对肺缺血的影响。
将肺脏（每组10个）安装在改良的Langendorff灌注装置上，用Krebs-Henseleit溶液灌注30分钟。在实验组中应用缺血预处理（5分钟缺血+5分钟灌注，重复两次）。在常温缺血3小时后，肺脏再灌注30分钟。在缺血期前后以及再灌注结束时测量肺动脉压力、组织和灌注液中的丙二醛（MDA）和谷胱甘肽（GSH）水平。在实验结束时，对每组随机选取的三只动物的肺脏进行电子显微镜评估。
再灌注后，实验组组织和灌注液中的MDA和GSH水平均下降，尽管GSH水平的下降未达到统计学意义。再灌注后，预处理组肺动脉压力的升高较低。
我们的数据表明，肺的缺血预处理可能对缺血再灌注损伤具有保护作用。
