Palazzo R, Hamvas A, Shuman T, Kaiser L, Cooper J, Schuster D P
Department of Surgery, Washington University Medical School, St. Louis, Missouri 63110.
J Appl Physiol (1985). 1992 Feb;72(2):612-20. doi: 10.1152/jappl.1992.72.2.612.
We developed an in vivo intact canine model to study pulmonary ischemia-reperfusion (IR) injury. The surgical approach simulates that of unilateral lung transplantation but is free of technical difficulties and other factors related to lung preservation. Serial measurements of regional pulmonary blood flow (rPBF), extravascular density (EVD), and transcapillary protein flux were made with the quantitative imaging technique of positron emission tomography. Eleven experimental and six control animals were studied. After 2 h of warm ischemia followed by reperfusion, no significant change occurred in rPBF despite significantly increased EVD, which was greater on the ischemic than on the nonischemic side. Protein flux, measured as a rate constant, was also greater on the ischemic than on the nonischemic side (median 181 x 10(-4)/min, range 104-619, vs. median 90, range 33-132) immediately after reperfusion. Both sides were also significantly different from control values (median 37, range 21-57). On both sides, protein flux decreased over time and at 5 h after reperfusion was not different from that of controls. Data from the control animals showed that these findings in the experimental animals were not due to surgical technique, deterioration in the surgical preparation, or hyperperfusion of the nonischemic lung. Thus IR injury of one lung can lead to similar, but less severe, injury in the contralateral lung. Because injury in the nonischemic lung develops only after reperfusion of the ischemic lung, injury to the nonischemic lung is probably humorally mediated. The model is a useful and relevant method for studying the physiological consequences of pulmonary IR injury.
我们建立了一种体内完整犬模型来研究肺缺血再灌注（IR）损伤。手术方法模拟单侧肺移植，但不存在技术难题以及与肺保存相关的其他因素。采用正电子发射断层扫描定量成像技术对局部肺血流量（rPBF）、血管外密度（EVD）和跨毛细血管蛋白通量进行连续测量。研究了11只实验动物和6只对照动物。在2小时的热缺血后再灌注，尽管EVD显著增加（缺血侧大于非缺血侧），但rPBF没有显著变化。以速率常数测量的蛋白通量在再灌注后即刻也是缺血侧大于非缺血侧（中位数181×10⁻⁴/分钟，范围104 - 619，相比之下，中位数90，范围33 - 132）。两侧也均与对照值有显著差异（中位数37，范围21 - 57）。两侧的蛋白通量均随时间下降，再灌注5小时后与对照无差异。对照动物的数据表明，实验动物的这些发现并非由于手术技术、手术准备的恶化或非缺血肺的过度灌注。因此，一侧肺的IR损伤可导致对侧肺出现类似但程度较轻的损伤。由于非缺血肺的损伤仅在缺血肺再灌注后发生，非缺血肺的损伤可能是由体液介导的。该模型是研究肺IR损伤生理后果的一种有用且相关的方法。
