沐舒坦对吸入性肺损伤大鼠的肺保护作用  

Prophylactic effect of ambroxol on acute hydrochloric acid aspirationinduced lung injury

作　　者：赵双平[1] 郭曲练[1] 艾宇航[1] 王瑞珂[1] 王锷[1] 贺民[1] 

机构地区：[1]中南大学湘雅医院麻醉科,湖南长沙410008

出　　处：《中国危重病急救医学》2005年第6期364-366,i002,共4页Chinese Critical Care Medicine

基　　金：湖南省科技计划项目(02SSY30111)

摘　　要：目的评价预先使用药物沐舒坦对稀盐酸吸入性肺损伤是否具有保护作用,为临床治疗提供理论依据。方法30只健康SD大鼠随机分成3组:A组为生理盐水吸入组;B组为稀盐酸吸入组;C组为稀盐酸吸入加沐舒坦处理组。C组预先以50mg/kg沐舒坦腹腔注射,每日1次,连续3d;A、B两组则以腹腔注射等体积生理盐水代替。第3d腹腔注射沐舒坦或生理盐水30min后,A组以1.2ml/kg(pH5.3)的生理盐水经气管内注入造成非盐酸吸入肺损伤作为对照;B、C组则以1.2ml/kg(pH1.25)的盐酸加生理盐水混合液经气管内注入制备盐酸吸入性肺损伤模型。观察盐酸注入5h后大鼠动脉血气、肺湿/干重比(W/D)以及光镜下肺组织病理改变及肺损伤评分。结果1B、C组动脉血氧分压(PaO2)在盐酸吸入5h时比A组明显降低,B组又低于C组,组间比较差异均有显著性(P均<0.01);但pH和动脉血二氧化碳分压(PaCO2)在3组间差异无显著性(P>0.05)。23组W/D由低到高依次为A组、C组和B组,组间比较差异均有显著性(P均<0.01)。3光镜下组织病理学观察发现,B组肺损伤最为严重,而C组损伤比B组要轻;肺损伤程度评分A组最低,C组较B组低,3组间比较差异有显著性(P<0.05或P<0.01)。结论沐舒坦能减轻稀盐酸吸入所引起弥漫性肺损伤。Objective To evaluate the protective effect of ambroxol, a mucoactive drug, on acute hydrochloricacidinduced lung injury in rats. Methods Thirty pathogen free SD rats were randomly dividedinto three groups: group A (n=10) and group B (n=10) were injected normal saline (NS) intraperitoneally(6.7 ml/kg), and group C with ambroxol (50 mg/kg), once a day for 3 consecutive days. Then animals received intracheal instillation of NS (group A, pH 5.3, 1.2 ml/kg) or hydrochloric acid/NS (group B and C, pH 1.25, 1.2 ml/kg). Five hours after instillation of the injury vehicle, the arterial gas was determined, and the extent of lung injury was assessed by measuring the ratio of wet to dry weight (W/D) and evaluationof pathological change in lung tissue. Results ①Partial pressure of oxygen in arterial blood (PaO_2) was significantly lower in group B than in groups A and C, although pH and partial pressure of carbondioxide in arterial blood (PaCO_2) in three groups showed little difference(all P<0.01). ②The W/D was the highest in group B and the lowest in group A. ③Severe acute lung injuries were detected in group B by pathological examination, the extent of injury was less in group C than in group B, but more severe than in group A (group A vs. B and B vs. C in mean pathologic score, P<0.01 and P<0.05 , respectively). Conclusion Hydrochloricacid aspiration may induce an acute and diffuse lung injury , with manifestations of hyperpnea, lower PaO_2 and severe pathological changes in lung tissues. Ambroxolmay have a protective effect against lung injury induced by hydrochloric acid.

关 键 词：沐舒坦 肺保护作用 动脉血二氧化碳分压 盐酸吸入性肺损伤 肺组织病理改变 生理盐水 气管内注入 腹腔注射 动脉血氧分压 肺损伤模型 肺损伤评分 病理学观察 显著性 临床治疗 SD大鼠 每日1次 动脉血气 程度评分 0.05 吸入组 

分 类 号：R563[医药卫生—呼吸系统]