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目的:探讨血红素氧合酶-1(HO-1)/一氧化碳(CO)径路在肺缺血-再灌注损伤中的作用。方法:采用在体兔单肺原位缺血-再灌注模型。实验兔40只,随机均分为假手术对照(C)组、肺缺血-再灌注(I-R)组、肺缺血-再灌注加氯铁血红素(H)组和肺缺血-再灌注加锌原卟啉(Z)组。分别在缺血前、缺血后、再灌注1h、2h、3h抽血,检测一氧化碳血红蛋白(COHb)浓度。实验结束时取肺组织检测湿干重比(W/D)、肺泡损伤率(IAR),观察肺组织超微结构的改变、HO-1的活力、表达部位及强度。结果:血浆COHb浓度,I-R组、H组明显高于C组,以H组为著(P<0.01);H组、Z组显著高于、低于I-R组(P<0.01)。肺组织HO-1活力H组最高,其次是I-R组,Z组和C组最低(P<0.05和P<0.01)。I-R组、H组、Z组HO-1在肺血管内皮、部分血管平滑肌、外膜层及部分气道上皮均有阳性表达,明显高于C组,尤以H组最为明显(P<0.01)。W/D、IAR值,I-R组和Z组均明显高于C组,尤以Z组为著,H组虽较C组为高,但显著低于IR组和Z组(P<0.05和P<0.01)。肺组织形态学异常改变,以Z组为著,H组较轻。结论:HO-1/CO径路对缺血-再灌注肺发挥积极的保护作用。
Objective: To investigate the role of heme oxygenase-1 (HO-1) / carbon monoxide (CO) pathway in lung ischemia-reperfusion injury. Methods: Single-lung ischemia-reperfusion model in rabbits. Forty rabbits were randomly divided into three groups: sham operation control group (C), lung ischemia - reperfusion group (IR), lung ischemia - reperfusion plus hemin group (H) and pulmonary ischemia - reperfusion Add zinc protoporphyrin (Z) group. Blood samples were collected before ischemia, after ischemia, and after reperfusion for 1h, 2h and 3h respectively to detect the concentration of COHb. At the end of the experiment, the wet / dry weight ratio (W / D), the rate of alveolar damage (IAR), the ultrastructure of lung tissue and the activity, the expression site and the intensity of HO-1 were detected. Results: Plasma COHb concentrations were significantly higher in I-R group and H group than those in C group (P <0.01). H and Z groups were significantly higher than those in I-R group (P <0.01). HO-1 activity in lung tissue was the highest in H group, followed by I-R group, the lowest in Z group and C group (P <0.05 and P <0.01). The expression of HO-1 in pulmonary vascular endothelium, part of vascular smooth muscle, adventitial layer and some airway epithelium in IR group, H group and Z group were significantly higher than those in C group, especially in H group (P <0.01) . W / D, IAR, IR group and Z group were significantly higher than those of C group, especially Z group, while H group was higher than C group, but significantly lower than IR group and Z group (P <0.05 and P <0.01). Abnormal lung tissue morphology changes, with the Z group as the H group lighter. CONCLUSION: HO-1 / CO pathway plays an active protective role in ischemia-reperfusion lung.