Matsumura A, Nakahara K, Miyoshi S, Mizuta T, Akashi A, Kawashima Y
First Department of Surgery, Osaka University Medical School, Japan.
J Surg Res. 1991 Mar;50(3):205-11. doi: 10.1016/0022-4804(91)90179-p.
The filtration coefficient (Kf) in Starling's equation for fluid exchange was estimated in isolated reperfused canine lobes to evaluate the effect of ischemia-reperfusion injury on alveolar-capillary permeability quantitatively and to determine the inhibitory effects of a high dose of methylprednisolone (MPS) or dimethylthiourea (DMTU), a potent hydroxyl radical scavenger, on this injury. We reperfused isolated canine left lower lobes (LLLs) with blood at a constant flow after 3 hr of warm (38 degrees C) or cold (4 degrees C) ischemia and measured Kf after 1 hr of reperfusion. The mean value of Kf (+/- 1 SD) in the cold ischemic lobes (COLD, n = 7), 0.13 +/- 0.04 g.min-1.cmH2O-1.100 g-1, was not different from that in the control nonischemic lobes (CONT, n = 6), 0.10 +/- 0.04 g.min-1.cmH2O-1.100 g-1. In contrast, the mean value of the Kf in the warm ischemic lobes (WARM, n = 7), 0.38 +/- 0.17 g.min-1.cmH2O-1.100 g-1, was significantly (P less than 0.001) higher than in CONT.MPS (30 mg/Kg) or DMTU (0.75 g/kg) administered before isolation of LLL and before reperfusion reduced the increase in Kf in warm ischemic lobes to 0.19 +/- 0.09 and 0.19 +/- 0.05 g.min-1.cmH2O-1.100 g-1, respectively (P less than 0.005 WARM vs MPS, and P less than 0.01 WARM vs DMTU). MPS and DMTU also attenuated the impairment of gas exchange. We conclude that (1) reperfusion after 3 hr of warm ischemia increases Kf but after cold ischemia does not, and (2) MPS and DMTU prevent the increase in Kf.(ABSTRACT TRUNCATED AT 250 WORDS)
在斯塔林流体交换方程中，通过对离体再灌注犬肺叶的研究来估算滤过系数（Kf），以定量评估缺血再灌注损伤对肺泡 - 毛细血管通透性的影响，并确定高剂量甲基强的松龙（MPS）或强力羟自由基清除剂二甲基硫脲（DMTU）对该损伤的抑制作用。在3小时的温缺血（38摄氏度）或冷缺血（4摄氏度）后，我们以恒定流量用血液对离体犬左下叶（LLL）进行再灌注，并在再灌注1小时后测量Kf。冷缺血肺叶（COLD，n = 7）的Kf（±1 SD）平均值为0.13±0.04 g·min⁻¹·cmH₂O⁻¹·100 g⁻¹，与对照非缺血肺叶（CONT，n = 6）的0.10±0.04 g·min⁻¹·cmH₂O⁻¹·100 g⁻¹无差异。相反，温缺血肺叶（WARM，n = 7）的Kf平均值为0.38±0.17 g·min⁻¹·cmH₂O⁻¹·100 g⁻¹，显著高于CONT组（P＜0.001）。在分离LLL前及再灌注前给予MPS（30 mg/kg）或DMTU（0.75 g/kg）可将温缺血肺叶中Kf的升高分别降至0.19±0.09和0.19±0.05 g·min⁻¹·cmH₂O⁻¹·100 g⁻¹（WARM组与MPS组相比P＜0.005，WARM组与DMTU组相比P＜0.01）。MPS和DMTU还减轻了气体交换的损害。我们得出结论：（1）温缺血3小时后再灌注会增加Kf，而冷缺血后则不会；（2）MPS和DMTU可防止Kf升高。（摘要截选至250字）
