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兔肺缺血再灌注后的微循环动力学与白细胞扣押

Microhemodynamics and leukocyte sequestration after pulmonary ischemia and reperfusion in rabbits.

作者信息

Kuhnle G E, Reichenspurner H, Lange T, Wagner F, Groh J, Messmer K, Goetz A E

机构信息

Institute of Anesthesiology, University of Munich, Germany.

出版信息

J Thorac Cardiovasc Surg. 1998 Apr;115(4):937-44. doi: 10.1016/s0022-5223(98)70377-0.

Abstract

OBJECTIVE

Investigation of leukocyte sequestration in alveolar capillaries and of microhemodynamic changes after pulmonary ischemia/reperfusion injury.

METHODS

The kinetics of leukocyte passage and the hemodynamics in pulmonary microcirculation were investigated in 16 rabbits by intravital microscopy. Mean red blood cell velocity and the number of sticking leukocytes were measured in pulmonary arterioles, venules, and capillaries after 1 hour of tourniquet ischemia and 10 minutes and 1 hour after reperfusion.

RESULTS

The decrease of red blood cell velocity after reperfusion was associated with a largely increased heterogeneity of blood flow. Immediately after the onset of blood flow, sequestered leukocytes were found in all microvascular segments. An increased number of leukocytes was present in arterioles, venules, and alveolar capillaries 10 minutes and 1 hour after reperfusion. Concomitantly, width of alveolar septa was increased while arterial oxygen tension was reduced, indicating the development of interstitial pulmonary edema.

CONCLUSION

Leukocytes are sequestered after pulmonary ischemia and reperfusion not only in alveolar capillaries but also in arterioles and venules, and they may contribute to the development of reperfusion edema.

摘要

目的

研究肺缺血/再灌注损伤后肺泡毛细血管中的白细胞滞留情况以及微循环动力学变化。

方法

通过活体显微镜观察,对16只家兔的肺微循环中白细胞通过的动力学和血流动力学进行研究。在止血带缺血1小时后以及再灌注10分钟和1小时后,测量肺小动脉、小静脉和毛细血管中的平均红细胞速度和黏附白细胞数量。

结果

再灌注后红细胞速度降低与血流异质性大幅增加相关。血流恢复后立即在所有微血管段发现滞留的白细胞。再灌注10分钟和1小时后,小动脉、小静脉和肺泡毛细血管中的白细胞数量增加。同时,肺泡间隔增宽而动脉血氧张力降低,提示间质性肺水肿的发生。

结论

肺缺血再灌注后白细胞不仅滞留在肺泡毛细血管中,也滞留在小动脉和小静脉中,它们可能促成再灌注性肺水肿的发生。

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