早产猪呼吸窘迫综合征模型的建立与治疗  

Establishment of respiratory distress syndrome in premature piglets treated with mechanical ventilation and porcine surfactant

作　　者：王晓宁[1] 孙波[1] 郭春宝[1] 孙中厚[1] 钱莉玲[1] 汪薇[1] 喻文亮[1] Karen Lu William Taeusch 

机构地区：[1]复旦大学附属儿科医院呼吸急救实验室,上海200032 [2]美国加利福尼亚大学旧金山分校儿科

出　　处：《中华围产医学杂志》2005年第5期334-337,共4页Chinese Journal of Perinatal Medicine

基　　金：国家自然科学基金项目(30170989);教育部211学科建设基金资助

摘　　要：目的建立早产猪呼吸窘迫综合征 (respiratory distress syndrome, RDS)模型并探讨猪肺表面活性物质(pulmonary surfactant, PS)制剂的治疗效果. 方法选择相当于足月孕期85%(94～97 d)的早产猪作RDS模型,随机分成4组(C组:对照组;C50组:PS 50 mg/kg;C100组:PS 100 mg/kg; N组:自主呼吸组).除N组外,其余早产猪气管切开插管,压力控制模式通气,吸入高浓度氧和标准潮气量通气.分别在治疗0～6 h测血气与呼吸力学参数,6 h后处死动物留取肺组织和肺泡灌洗液(bronchoalveolar lavage, BALF)进行形态学与生化分析. 结果 RDS动物BALF中总磷脂约10 mg/kg;电子显微镜下板层小体仅零星可见;光学显微镜下可见肺泡基本处于萎陷状态.C100组PaO2/FiO2由(92±37)上升到(235±137)mm Hg,肺顺应性由(0.48±0.08)上升到(0.76±0.29)ml/(cm H2O·kg),肺泡扩张均匀,少见损伤;C50组肺氧合及呼吸力学改善不明显. 结论早产猪RDS模型用于研究新生儿呼吸系统疾病具有一定价值,100 mg/kg的PS对肺氧合、呼吸力学及形态学的改善具有明显作用.Objective To establish a respiratory distress syndrome （RDS） model of piglets and assess the therapeutic effect of pulmonary surfactant （PS） on gas exchange, lung mechanics and morphology. Methods Preterm newborn piglets were delivered by cesarean section at 94- 97 days of gestation for determination of lung immaturity. Littermates were randomly divided into 4 groups： Group C50 were treated with 50 mg/kg for 6 h and group C100 with 100 mg/kg Curosurf; group C was the control group and group N received no ventilation. Blood-gas analyses and lung mechanic measurement were performed per hour. At the end of the experiment, the lungs were processed for biochemical, biophysical and histopathological analyses. Results Surfactant deficiency in RDS was shown with the low total phosphollpids （TPL） level in bronchoalveolar lavage （BALF） in premature piglets at 94-97 days of gestation with marked difficulty in spontaneous respiration and morphological evidence of poor alveolar aeration and paucity of lamellar bodies in type Ⅱ alveolar epithelial cells. The group C had typical lung injury of RDS, the C100 and C50 group had variable but significantly improved alveolar phospholipid, alveolar aeration and wet-to-dry lung weight ratio. PaO2/FiO2 was improved from （92±37） mm Hg to （235± 137） mm Hg, and the dynamic compliance （Cdyn） from （0. 48±0. 08） to （0. 76±0. 29） ml/（cm H2O · kg） in group C100. But mild effects was shown in group C50. Conclusion A premature piglet RDS model is established and valuable for investigation of mechanism of lung injury in early life after born.

关 键 词：呼吸窘迫综合征 新生儿 肺表面活性剂 呼吸 人工 疾病模型 动物 猪肺表面活性物质 呼吸窘迫综合征 治疗效果 早产 模型 SURFACTANT 呼吸力学参数 syndrome 肺泡灌洗液 

分 类 号：R722.6[医药卫生—儿科]