Contribution of alveolar lymphocytes to acute lung injury.

为了评价轻度高碳酸血症对肺泡细胞功能的影响，我们研究了维持轻度高碳酸血症或正常高碳酸血症的麻醉患者，分别在诱导后即刻、麻醉诱导后2、4、6小时和手术结束时采集肺泡细胞。对其吞噬和杀菌活性进行了评价。同时，将收获的细胞溶解在鸟嘌呤缓冲液中。提取总RNA，用逆转录酶合成c DNA。以IL-1β、8、干扰素-γ、肿瘤坏死因子-α为特异性引物，用聚合酶链式反应进行半定量分析，用流式细胞术检测中性粒细胞和巨噬细胞来源的黏附分子CD10a、b、c、CD18、49d、54和淋巴细胞来源的黏附分子(CD4、8)，吞噬功能和杀菌功能的各项指标均无组间差异。然而，Pro-INFL…的表达高碳酸血症患者的炎症细胞因子、活化的淋巴细胞以及中性粒细胞和巨噬细胞来源的黏附分子明显高于正常碳酸血症患者。我们的结果提示，轻度高碳酸血症可能在麻醉和手术期间保护肺炎性反应。2.手术大小严重调节肺泡细胞功能。我们评估了手术大小对肺泡巨噬细胞功能的影响。研究方案已经在前面描述过了。促炎症细胞因子、活化的淋巴细胞和黏附分子的表达随着手术量的增加而显著增加。巨噬细胞吞噬功能和杀菌活性的降低在接受大手术的患者中更为明显。这些结果表明，手术量的增加严重加重了肺功能。3.围手术期低温降低了所有肺泡细胞功能。我们评估了手术量对肺泡巨噬细胞功能的影响。所有的肺泡细胞功能在低温下都降低了。这些结果可能意味着术后肺部感染率的增加。较少

1.Effects of alveolar lymphocytes on mild hypercapneaTo evaluate the mild hypercapnea on alveolar cell functions, we studied anesthetic patients maintained mild hypercapnea or normocapnea.To harvest alveolar cells were performed immediately after induction, 2,4,and 6 hours after induction of anesthesia, and at the end of the surgery. Phagocytic and microbicidal activities were evaluated. Also, harvested cells were dissolved in guanidinium buffer. Total RNA was isolated and cDNA was synthesized with a reverse transcriptase. By specific primers of interleukin-1beta and 8,interferon-gamma, tumor necrosis factor-alpha, semi-quantitative analysis was performed by polymerase chain reaction.We analyzed neutrophil and macrophage derived adhesion molecules including CD10a,b,c,CD18,49d,and 54,and lymphocyte derived adhesion molecules(CD 4 and 8) by a flowcytometry.Inter-group differences were not detected in any parameters of phagocytic and microbicidal functions. However, Expression of pro-infl … More ammatory cytokines, activated lymphocytes and neutrophil and macrophage derived adhesion molecules were much greater in hypercapneic patients than in normocapneic patients.Our results suggest that mild hypercapnea may protect pulmonary inflammatory reactions during anesthesia and surgery.2.Operative magnitude seriously modulates alveolar cell functions.We evaluated the effects of operative magnitude on alveolar macrophages functions.We studied patients undergoing major, moderate and minor surgery. Study protocol was described previously. Expression of pro-inflammatory cytokines, activated lymphocytes, and adhesion molecules significantly increase as the operative magnitude increased. The decrease in phagocytic and microbicidal activities was much greater in patients undergoing major surgery.These results suggest that increase in operative magnitude seriously aggravate pulmonary functions.3.Perioperiative hypothermia decreases all alveolar cell functions.We evaluated the effects of operative magnitude on alveolar macrophages functions.We studied perioperative hypothermic and normothermic patients. All alveolar cell functions decreased by hypothermia.These results may imply increase in rate of postoperative pulmonary infections. Less