Fadel E, Mazmanian G M, Chapelier A, Baudet B, Detruit H, de Montpreville V, Libert J M, Wartski M, Herve P, Dartevelle P
Laboratoire de Chirurgie Experimentale, Centre Chirurgical Marie Lannelongue, Université Paris Sud, Le Plessis Robinson, France.
Am J Respir Crit Care Med. 1998 Apr;157(4 Pt 1):1294-300. doi: 10.1164/ajrccm.157.4.9707063.
Because the lungs receive their blood supply from both the pulmonary and bronchial systems, chronic pulmonary artery obstruction does not necessarily result in severe ischemia. Ischemia-reperfusion (IR) lung injury may therefore be attenuated after long-term pulmonary artery obstruction. To test this hypothesis, isolated left lungs of pigs were reperfused two days (acute IR group) or 5 wk (chronic IR group) after left pulmonary artery ligation and compared to those of sham-operated animals. The severity of IR-lung injury after 60 min ex vivo reperfusion of the left lung was assessed based on lung histology and measurements of filtration coefficient (Kfc), pulmonary arterial resistance (Rpa), and lung myeloperoxidase (MPO) activity. Marked bronchial circulation hypertrophy was seen in the chronic IR group. Hemorrhagic alveolar edema was found in all acute IR lungs but not in sham or chronic IR lungs. Compared with the sham-operated controls, Kfc and Rpa increased two-fold and threefold, and MPO 1.5-fold and twofold in the chronic and acute IR groups, respectively. In conclusion, IR-induced lung injury was markedly reduced when it occurred 5 wk after pulmonary artery ligation, probably because the systemic blood supply to the lung had time to develop, limiting ischemia.
由于肺脏从肺循环和支气管循环系统接受血液供应，慢性肺动脉阻塞不一定会导致严重缺血。因此，长期肺动脉阻塞后，缺血再灌注（IR）肺损伤可能会减轻。为了验证这一假设，将猪的离体左肺在左肺动脉结扎后两天（急性IR组）或5周（慢性IR组）进行再灌注，并与假手术动物的肺进行比较。基于肺组织学以及滤过系数（Kfc）、肺动脉阻力（Rpa）和肺髓过氧化物酶（MPO）活性的测量，评估左肺离体再灌注60分钟后IR肺损伤的严重程度。在慢性IR组中可见明显的支气管循环肥大。在所有急性IR肺中均发现出血性肺泡水肿，但在假手术或慢性IR肺中未发现。与假手术对照组相比，慢性和急性IR组的Kfc和Rpa分别增加了两倍和三倍，MPO分别增加了1.5倍和两倍。总之，当肺动脉结扎5周后发生IR时，IR诱导的肺损伤明显减轻，这可能是因为肺的体循环血液供应有时间发展，限制了缺血。
