摘要
目的探讨细胞外组蛋白在肺移植术后血浆中的变化及临床意义。方法选取20例肺移植患者,15例开胸手术对照组和15例健康志愿者作为健康对照组。分别检测肺移植组及开胸手术对照组术前(T1)、术后0 h(T2)、术后24 h(T3)、术后48 h(T4)、术后72 h(T5)及术后7 d(T6)血浆中细胞外组蛋白水平。结果肺移植患者术后细胞外组蛋白水平显著高于术前及健康对照组( P <0.001);术后0时达至峰值(中位数: 0.351 μg/mL;四分位数间距: 0.114,0.468 μg/mL),术后24~72 h呈逐渐下降趋势,但仍高于术前水平。与开胸手术对照组各时间点相比,肺移植组术后细胞外组蛋白水平均高于开胸手术对照组( P <0.001);其中1例原发性移植肺失功(primary graft dysfunction, PGD)患者的细胞外组蛋白水平各时间点均显著高于非PGD患者,持续处于较高水平。结论细胞外组蛋白在肺移植术后显著升高,并且在PGD病程中持续处于较高水平,可能与供肺的缺血再灌注损伤有关,在肺移植早期并发症如PGD中发挥重要作用。
Objective To investigate the changes of plasma extracellular histone levels following lung transplantation and its clinical significance. Methods Twenty patients with lung transplantation and 15 patients with thoracotomy (surgical control), and 15 healthy subjects (normal control) were recruited in the study. The plasma levels of extracellular histones were measured before operation (T1), 0 h (T2), 24 h (T3), 48 h (T4), 72 h (T5) and 7 d (T6) after operation. Results The plasma extracellular histones levels of patients with lung transplantation were significantly higher than those in the normal control group ( P <0.001). The levels reached the peak at T2 [0.351(0.114, 0.468)μg/mL] and then gradual declined from T3 to T5, but still higher than that at T1. The extracellular histones level in lung transplantation group were higher than those in surgical control group at various time points ( P <0.001). The extracellular histones level in a patient with primary graft dysfunction (PGD) were significantly higher than other patients at different time points and remained at a high level. Conclusion Plasma extracellular histones levels are significantly elevated following lung transplantation, indicating that it may be associated with lung ischemia-reperfusion injury, and it may play an important role in the development of PGD.
作者
孙梦
江雪梅
金杨
温宗梅
SUN Meng;JIANG Xue-mei;JIN Yang;WEN Zong-mei(Dept. of Anesthesiology, Shanghai Pulmonary Hospital, Tongji University, Shanghai 200433, China;Dept. of Anesthesiology, Second Affiliated Hospital of Nanchang University, Nanchang 330006, Jiangxi Province, China)
出处
《同济大学学报（医学版）》
CAS
2019年第3期361-364,共4页
Journal of Tongji University(Medical Science)
基金
中央高校基本科研业务费专项资金(22120170168)
同济大学附属上海市肺科医院创新群体基金(2019fkcx1906)
上海市自然科学基金(19ZR1443000)
关键词
细胞外组蛋白
肺移植
原发性移植肺失功
extracellular histones
lung transplantation
primary graft dysfunction
