Lung reperfusion injury after chronic or acute unilateral pulmonary artery occlusion
Lung reperfusion injury after chronic or acute unilateral pulmonary artery occlusion
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DOI：
10.1164/ajrccm.157.4.9707063
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发表时间：
1998-04-01
影响因子：
24.7
通讯作者：
Dartevelle, P
中科院分区：
文献类型：
--
作者：
Fadel, E;Mazmanian, GM;Dartevelle, P
由于肺从肺和支气管系统接受血液供应，慢性肺动脉阻塞并不一定导致严重缺血。因此，长期肺动脉阻塞后，缺血再灌注（IR）肺损伤可能减轻。为了验证这一假设，在左肺动脉结扎后2天（急性IR组）或5周（慢性IR组）对离体猪左肺进行再灌注，并与假手术动物进行比较。根据肺组织学、滤过系数（K-fc）、肺动脉阻力（Rpa）、肺髓过氧化物酶（MPO）活性等指标评估左肺离体再灌注60 min后ir -肺损伤的严重程度。慢性IR组可见明显的支气管循环肥大。急性IR肺均可见出血性肺泡水肿，而假肺和慢性IR肺均未见。与假手术对照组相比，慢性和急性IR组K-fc和Rpa分别增加了2倍和3倍，MPO分别增加了1.5倍和2倍。综上所述，在肺动脉结扎后5周，ir引起的肺损伤明显减轻，这可能是因为肺部的全身血液供应有时间发展，限制了缺血。
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 (K-fc), 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, K-fc and Rpa increased twofold 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.