Expression Of Cell Adhesion Molecules In Rabbit Models Undergoing Cardiopulmonary Bypass And The Pulmonary Protective Effect Of Ulinastatin

[Objective] : Techniques of cardiopulmonary bypass have been widely applied on cardiac surgery, but the acute lung injury (ALI) is still the most important complications after cardiopulmonary bypass (CPB) and the complex pathophysiology remains to be resolved incomplete. Presently, some studies showed that adhesion molecules maybe act the most important role in the acute lung injury. Models of CPB in rabbit were used to investigate the expression of cell adhesion molecules different time in operation and to investigate the protecive effect of Ulinastatin during the procedure, and flow cytometry , electron microscope, immunohistochemistry(SABC) had been studied.[Methods] : part Ⅰ:To establish a new rabbit model of CPB:20 New Zealand rabbits were used in the experiment, Servo 900B respirator was to assist anesthetized rabbit' s respiration after tracheal cannula, artery press through artery spile in left external carotid artery. CPB was established via right common carotid artery and right atrium cannulation. Electrocardiograph, temperature, blood saturation, and arterial blood gases were monitored during the experiment . As the beginning of the CPB, the temperature was reduced to 28°C by ice water , blood flow of primarily pulmonary artery of rabbit were occluded about 30 minute then resume the blood flow and normal temperature was resumed. The time of CPB is 90 min . After CPB , we need dopamine support the circulation, respirator support respiration 3~4h.part Ⅱ: The expression of cell adhesion molecules and the possible pulmonary protective effect of Ulinastatin in CPB:20 New Zealand rabbits were random divided in two groups. UTI group(UTI 10, 000U/kg in CPB prepare liquid and add another 10, 000U/kg UTI in primarily pulmonary artery after block the primarily pulmonary artery.) and antagonist group . we establish the same model and draw pulmonary vein blood in six different time , after exocentric we get the serum. We use ELISA immunohistochemistry (SABC) to examine the expression of ICAM-1 and flow cytometry (FCM) to examine the expression of CD11b/ CD18 of neutrocyte. The examine also including dry wet ratio of lung tissues , Pa02/ Fi02 and histological changes , were studied to illustrate the possible mechanism of cell adhesion molecules in lung reperfusion injury. We contrast the results of the two groups.Data were analyzed by software SPSS and Excel 2000. [Results] : (1)CPB of rabbit can established via right common carotid artery and right atrium cannulation. This method maybe easy, economy and efficacious.(2) In the antagonist group, The expression of ICAM-1 and CD11b/ CD18 quickly rise when the begine of CPB, then has an another rise at the time of resume primarily pulmonary artery, it reach the peak after the over of CPB. Dry wet ratio of lung tissues , Pa02/ Fi02 and histological changes demonstrate the lung injury is so hard.(3) In the group of Ulinastatin, the expression of ICAM-1 and CD11b/ CD18 have the same regular change. But, the amount of the behind five time also lower than CPB group. Dry wet ratio of lung tissues , Pa02/ Fi02 and histological changes demonstrate the lung injury is also lower injury than CPB group.[Conclusion] : Cell adhesion molecules might lead to lung injury during CPB , Ulinastatin may relieve lung injury and enhance the recovery of lung function.