关键词: 肺 , 体外循环, 再灌注损伤, 腺苷

Abstract: Objective: To evaluate the protective effect of perfusion of the pulmonary artery using cold oxygenated blood containing adenosine on the ischemia-reperfusion injury of the lung during cardiopulmonary bypass. Methods: Thirty patients undergoing heart valve replacement complicated with pulmonary hypotension with cardiopulmonary bypass were randomly divided into the control group (n=15，　infused with 4 ℃ oxygenated blood) and the adenosine group (n=15，　infused with 4 ℃ oxygenated blood containing adenosine). The plasma level of TNFα, IL-6, MDA and the V/A (vein/artery) ratio of WBC were determined before CPB and at 15 minutes after aortic cross-clamp, 15 minutes after aortic cross-clamp release, 12 hours after the operation and 24 hours after the operation. Results: The time of mechanical ventilation was significantly shorter in the adenosine group than that in the control group［（18.60±4.75）h VS （26.40±6.32）h，P＜0.05］. Compared with the control group, the WBC V/A，as well as the level of IL-6 and TNF－α of the adenosine group was significantly decreased at 15 minutes after aortic cross-clamp， 15 minutes after aortic cross-clamp release and 12 hours after the operation (P＜0.05). The level of MDA was also obviously decreased at 15 minutes after aortic cross-clamp release, 12 hours after the operation and 24 hours after the operations(P＜0.05). Conclusion: Perfusion with cold oxygenated blood containing adenosine to the pulmonary artery can more effectively reduce the ischemia-reperfusion injury of the lung than that with only cold oxygenated blood during CPB.

Key words: Adenosine, Cardiopulmonary bypass, Reperfusion injury, Lung