左旋精氨酸对离体兔肺脏保存质量的影响

　　摘要　观察左旋精氨酸对离体兔肺脏保存的保护作用，健康家兔随机分成对照组(EC组)和实验组(Arg组)，每组15只，EC组兔肺脏予Euro-collins液进行灌洗，Arg组予含左旋精氨酸的EC液进行灌洗肺脏，灌洗总量60 ml/kg，灌注压力20 cm水柱，灌毕完整取下心肺组织浸入保存液4℃环境冷藏，7 h后取肺进行离体复灌，测定肺血管阻力，血气分析，肺血管对Ach舒血管反应性，肺组织湿干重比例及肺组织电镜检查等指标。EC组肺血管阻力，肺组织湿干重比例均高于Arg组，肺血管对Ach反应性EC组较Arg组差，血气指标EC组下降明显，Arg组肺组织形态轻微改变，而EC组水肿明显渗出严重。左旋精氨酸具有改善离体兔肺脏的保存效果。

The Effect of L-Arginine on Rabbit Lung Preservation

Wang Qimin,Liao Chongxian,Chen Daozhong

　　(Department of cardiac surgery,Union Hospial Fujian Medical

　　University,Fuzhou,Fujian　350001)

　　Abstract　The effect of L-Arginine Arg on lung preseration Method: 30 rabbits were divided into Euro-collins(EC)and Arg groups.Lung were flushed with EC solution in EC group,and Args group with Arg solution which contained 0.2 mg/ml L-Arginine.After being flushed the heart-lung blocks were harvested and stored in 4 ℃ cold solution for 7 hours.The lungs were reperfused with flesh venous blood.Pulmonary vascular resistance (PVR),blood gas analysis,achinduced vosodilation.lung tissue wet/dry ratio and histologic changes were observed.Result:the W/D and PVR were higher in EC group than those in Arg group.Ach-induced vosodilation and the vesults of blood gas analysis were better in Arg group than those in EC group.Histologic changes were minimal in Arg group.Conclusion:L-Arginine improved the quality of rabbit lungs preservation,which might be the result of its endothelial protection.

　　Key words:L-Arginine; Lung preservation

　　近年来，随着基础研究的深入，血管内皮细胞的功能日益受到重视，许多证据表明内皮功能损害，一氧化氮(NO)合成减少与组织缺血再灌注损伤关系密切［1］，也发现低温保存后的肺脏血管，内皮功能受损［2］，因此，如何保护肺血管内皮细胞减轻缺血再灌注损伤，成为离体器官保存研究的新课题。外源性左旋精氨酸能够促进内皮细胞的NO合成，对组织缺血再灌注损伤具有保护作用［3～4］，作者在Euro-collins(EC)液中加入左旋精氨酸，观察其对离体兔肺的影响。

　　材料和方法

　　1.研究对象及分组　健康家兔30只(由福建医科大学实验动物中心提供)，体重1.7～2.4 kg，按照随机原则，分为对照组(EC组)和实验组(Arg组)，每组15只。EC组应用EC液，Arg组在EC液中加入左旋精氨酸0.2 mg/ml。

　　2.实验步骤　兔芬太尼10～20 ug/kg经耳缘静脉注射后，全麻，气管切开，接呼吸机(DH-10型，浙江医科大学)，调节呼吸频率40次/min，潮气量15 ml/kg，予空气通气。兔去毛消毒，前正中线开胸，剪除纵隔胸膜切除胸腺暴露气管，打开心包，游离上下腔静脉，

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