摘要
目的:探讨应用平阳霉素-碘化油乳剂实现功能性肺叶切除(Functional pulmonary lobectomy,FPLT)的安全性、肺小动脉病理变化及血管内皮生长因子(Vascular endothelial growth factor,VEGF)表达情况,评价其对肺循环的影响。方法:健康犬18只,随机分成2组,肺叶切除组(FPLT)12只行靶肺支气管肺泡灌注平阳霉素-碘化油乳剂,并用支气管封堵器堵塞靶支气管,对照组6只。分别于14、28、56 d处死取肺组织。分析肺纤维化的程度及肺血管VEGF表达情况;测量中膜厚度指数(TI)、肺小动脉面积指数(AI)。结果:肺叶切除组术后靶肺叶毁损、萎缩、纤维化,非靶肺未见明显纤维化,VEGF高于对照组(P<0.05),肺小动脉管壁增厚,管壁厚度指数及面积指数明显增高(P<0.05),非靶肺小动脉无血管重构现象。结论:靶肺支气管肺泡灌注平阳霉素-碘化油乳剂后靶支气管堵塞可达到功能性肺叶切除目的。VEGF含量的变化与肺损伤后血管变化有一定关系,TI、AI增高,有利于调节术后通气-血流比,对肺循环无明显不良影响。
Objective To investigate the safety of Functional Pulmonary Lobectomy（FPLT） and observe the changes of puimonary arterioles and VEGF expression after FPLT. Methods Eighteen healthy dogs were divided into two groups randomly： FPLT group （n=12）： Pingyangmycin （PYM） lipiodol emulsion was injected to the target lung, and the target bronchia was obstructed with broncho-occluder by catheter, control group （n=6）. Four dogs of FPLT group and two dogs of control group were sacrificed on the 14th, 28th and 56th day, respectively. The expression of Collagen- Ⅲ and VEGF were measured by immunohistochemical technique. The thickness index （TI） and vessel wall area index （AI） were measured. Resuits It was showed histopathologicaUy that different extent of atrophy and fibrosis was appeared in the target lung in FPLT group, and no fibrosis in non-target lung after FPLT. The VEGF expression in FPLT group was higher than that in non-target lung and control group. The thickness of middle and small pulmonary arterial wall was increased. No fibrosis and no vascular remodeling was observed in non-target lung after FPLT. Conclusion FPLT might be obtained after Pingyangmycin （PYM）lipiodol emulsion was injected to the target lung and the target bronchia was obstructed with broncho-occluder by catheter. The high VEGF expression may correlate with vascular change in lung injury and the increase of TI and AI was benificial to improve gas exchange disorders of postoperation. There was no poor influence on the pulmonary circulation after FPLT.
出处
《郧阳医学院学报》
2008年第1期5-8,F0002,共5页
Journal of Yunyang Medical College
关键词
肺切除术
肺纤维化
肺小动脉
血管重构
Pulmonary lobectomy
Fibrosis
Pulmonary arterioles
Vascular remodeling
