| Objective To oberserve the conservation effective and mechanism of ulinastatin and ischemic preconditioning to the lung that received Ischemia/Reperfusion , and the mechanism of the protection to lung Ischemia /Reperfusion surgery of ulinastatin combining with ischemic preconditioning . Methods 24 adult healthy New Zealand rabbits of either sex were randomly divided into four equal groups,6 rabbits in each group. The Control group ( only recived Ischemia/Reperfusion in left lung ),the IPC group (received Ischemia / Reperfusion in left lung after reapeat to blocking hlium of lung for five minutes and reopen for five minutes ), The UTI group (received Ischemia / Reperfusion in left lung and ulinastatin 10000u / kg intravenous injection ), The UTI+IPC group ( recived Ischemia / Reperfusion in left lung and ulinastatin combining with ischemic preconditioning ). to ligate the hilum of left lung with atraumatic suture of 1-0 for five minuts and reperfus for five minuts after open the left chest , once again in IPC,lasting for ten minuts (thirty minuts in Control and UTI), then to ligate the hilum of left lung for 60 minuts, and to reperfus for 120 minuts as the model of lung Ischemic /Rperfusion ( I / R ) .In vivo I/R injury of rabbit was induced by blocking hilum of the left lung . The protective roles of IPC, UTI, and UTI + IPC on ischemia reperfusion injury of lung were observed. To draw the arterial blood at four time (before ischemic, ischemic fore 60 minuts ,30 minuts of reperfusion, 120 minuts of reperfusion), to measure the peripheral white blood cells(PWBC), blood gas analysis(PaO2 , PaCO2 ), wet / dry(W / D) ratio of lung, lung permeability index ( LPI ) and neutrophils percentage in bronchoalveolar lavage fluid ( BALF ) were detected as index of the lung injury. Serum levels of superoxide dismutase ( SOD ), malondialdehyde ( MDA ) , nitric oxide ( NO ) and the myeloperoxidase ( MPO ) in lung tissue were detected using chemistry colorimetric. To examine the degree of lung tissue damage (LTD) by view of the histological appearances of lung under light microscope. Result After 60 minutes ischemic and 120 minutes reperfusion, the peripheral white blood cells ( PWBC ) in the four groups are all decrease at the time of reperfusion for 30 minuts, but the lowest is in Control group(P<0.01); conferred to Control the W/D, LPI, quantity of WBC in BALF,MDA and MPO activity were significantly lower in IPC grop , UTI group than those of the control group ( all P<0.001 or P<0.005 , respectively ), and PaO2, SOD and NO are significantly higher than those in Congtrol group. ( all P<0.001 or P<0.005, respectively ). tissues demonstrated the degree of lung injury had been alleviated significantly. The protective effect in UTI + IPC group is more singnificantly. than in UTI group and IPC group. Conclusion: 1, Ligating/loosening the left lung hilum of the rabbits is a good model of Ischemic Rperfusion ( I/R ), the lung Ischemia Reperfusion surgery is certainly exist, and the first peak of lung injury at 30 minuts of reperfusion . 2,The neutrophil been collected up in lung , the more oxyradical generation , and the decrease of NO are the important factors in making the lung Ischemic Reperfusion surgery. 3, Both IPC and UTI have important protection to the lung tissues. 4,The protective effect of the lung tissues is more significantly by UTI combining with IPC than that by IPC or UTI lonly. 5,The common mechanism of protective of UTI and IPC on lung Ischemia /Reperfusion injury is that to reduce the neutrophil sequestration within the lung , increase the activity of NO and decrease the amount of oxygen-derived free radical in lung .
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