Kukkonen S, Heikkilä L, Verkkala K, Mattila S, Toivonen H
Department of Anesthesiology, Helsinki University Central Hospital, Finland.
J Heart Lung Transplant. 1996 Apr;15(4):409-14.
The ischemia-reperfusion lung injury is characterized by increased pulmonary vascular resistance, edema, and subsequent deterioration of oxygenation. Other models of acute lung injury suggest that thromboxane A2 may contribute to the pulmonary hypertension after transplantation.
We studied the effects of the selective thromboxane A2 receptor antagonist SQ 30741 on pulmonary hemodynamics and gas exchange in porcine single lung transplantation using extracorporeal circulation (right heart bypass) with separate cannulations of the right and left pulmonary arteries. Pulmonary vascular resistance was measured at equal and constant flow to each lung. Flow distribution between the lungs was registered at equal pulmonary artery pressures. Twelve pigs (weight 17 to 23 kg) were studied. At the onset of reperfusion a bolus dose of the drug (5 mg/kg) was injected into both pulmonary arteries followed by an infusion (5 mg/kg/hr) for 1 hour (SQ group, n = 6). The control group (n = 6) received an equal amount of vehicle. The systemic and pulmonary hemodynamics and blood gas values were registered during 2 hours of reperfusion.
The pulmonary vascular resistance of the transplanted lung was significantly higher compared with the native lung (p < 0.001). Administration of SQ 30741 failed to ameliorate the pulmonary pressor response of the graft in comparison with the control group. No difference was found in the systemic arterial oxygen tension between the two groups.
Thromboxane does not seem to be among the principal mediators in the pulmonary hypertension after transplantation.
缺血再灌注肺损伤的特征是肺血管阻力增加、水肿以及随后的氧合恶化。其他急性肺损伤模型表明，血栓素A2可能导致移植后的肺动脉高压。
我们使用体外循环（右心旁路），通过分别插管左右肺动脉，研究了选择性血栓素A2受体拮抗剂SQ 30741对猪单肺移植中肺血流动力学和气体交换的影响。在每个肺的流量相等且恒定的情况下测量肺血管阻力。在肺动脉压力相等时记录两肺之间的血流分布。研究了12头猪（体重17至23千克）。在再灌注开始时，将一剂推注药物（5毫克/千克）注入两条肺动脉，然后以输注（5毫克/千克/小时）持续1小时（SQ组，n = 6）。对照组（n = 6）接受等量的赋形剂。在再灌注的2小时内记录全身和肺血流动力学以及血气值。
与天然肺相比，移植肺的肺血管阻力明显更高（p < 0.001）。与对照组相比，给予SQ 30741未能改善移植物的肺升压反应。两组之间的体动脉氧张力没有差异。
血栓素似乎不是移植后肺动脉高压的主要介质之一。
