摘要
目的 探讨外源性肺表面活性物质(PS)对经气道滴入内毒素诱发大鼠急性呼吸窘迫综合征(ARDS)肺内炎症反应的影响。方法 32只健康雄性SD大鼠,手术并给予机械通气(MV),吸入氧浓度(FiO_2)为50％,并随机分为4组:(1)健康对照组(H组);(2)ARDS模型组(M组);(3)早期治疗组(PaO_k/FiO_2≤300mm Hg,ALI期,E组),经气道滴入PS100mg/kg;(4)晚期治疗组(PaO_2/FiO_2≤200mm Hg,ARDS期,L组),PS剂量与用法同E组。PS治疗后6h处死动物。测定支气管肺泡灌洗液(BALF)中白细胞(WBC)数、总蛋白(TP)、肿瘤坏死因子α(TNF-α)、白细胞介素1β(IL-1β)、巨噬细胞炎症蛋白2(MIP-2)和肺匀浆中的丙二醛(MDA)、超氧化物歧化酶(SOD)和谷胱甘肽(GSH)含量。结果 M组BALF中的WBC、TP、TNF-α、IL-1β和MIP-2均较H组明显增加(P值均<0.01),L组仅TP、IL-1β和MIP-2较M组降低(P值均<0.01),而E组上述各指标均较M组和L组进一步降低(P<0.05或P<0.01),且E组大鼠肺脏局部氧化反应明显抑制,抗氧化能力增强。肺病理见M组呈严重急性肺损伤,L组有所减轻,E组则明显减轻。结论 ARDS早期应用PS能够显著抑制肺内炎症反应,减轻肺损伤。
Objective To examine effects of a porcine pulmonary surfactant (PS) on lung inflammation in experimental rat model of acute respiratory distress syndrome (ARDS) .Methods Thirty-two healthy male adult Sprague-Dawley rats were surgical operated and mechanically ventilated with 50% oxygen (FiQ2).8 animais received no endotoxin were served as healthy control group (H) .24 animals were adminstered 50 nig/ kg of endotoxin intratrachaeally to induce ARDS. When arterial hlood O2 (PaO2) / FiO2≤300 mm Hg.the animals were randomly allocated to 3 groups ( H = 8 each): ARDS model group (M) not receiving PS, immediate ( i.e.early stage) treatment with PS at a dose of 100 mg/kg (E)administered intratrachaeally, late stage(when PaO2;/FiO2≤200 mm Hg,approximately 2 h later) treatment with PS used as E group(L) ,and were ventilated for another 6 h. Total while blood cells (WBC) were counted and the contents of total proteins(TP) ,TNF-α, IL-1β,microphage inflammatory protein 2 (M1P-2) in BALF and MDA,SOD,GSH levels in the lung homogenates were assayed,respectively . Lung histological changes were examined under a light microscope. Results The M group had increased WBC,TP,TNF-α, IL-1β,MIP-2 in BALF, increased MDA,and decreased SOD and GSH in the lung homogenate (all P<0.01) as compared with the H group, whereas TP, IL-1β,MIP-2, MDA and SOD in the L group were modestly but statistically significant improved (P<0.05 or P<0.01) as compared with the M group,and the E group showed further improvement of all measurements above ( P< 0.05 or P<0.01) as compared with the M group and the L group. Hislological examination revealed severe acute lung injury in the M group,both L group and E group showed less severe than M group,but it was lighter in the E group than the L group.Conclusion Exogenous PS is more effective in reducing lung inflammation and attenuating lung injury when it is used at the early stage of ARDS.
出处
《中国呼吸与危重监护杂志》
CAS
2002年第4期206-209,共4页
Chinese Journal of Respiratory and Critical Care Medicine
基金
上海市卫生局青年科研基金(131984Y5)
