部分液体通气联合伊洛前列素治疗兔油酸型急性肺损伤  

Effect of inhalation of aerosol iloprost during partial liquid ventilation on acute lung injury in rabbits induced with oleic acid

作　　者：宋鹏[1] 李琦[1] 王长征[1] 易斌[1] 黄勇[1] 钱桂生[1] 

机构地区：[1]第三军医大学新桥医院全军呼吸内科研究所全军呼吸病研究重点实验室,重庆400037

出　　处：《第三军医大学学报》2006年第6期587-590,共4页Journal of Third Military Medical University

摘　　要：目的观察部分液体通气(partial liqu id ventilation,PLV)联合气道内给予血管扩张药伊洛前列素对急性肺损伤(acute lung in jury,ALI)兔肺气体交换、肺力学方面的影响。方法健康大白兔24只,用油酸混合兔血清复制成ALI模型后随机分为3组。各组采用不同治疗方法:常规机械通气组(conventionalm echan ical ventilation,CMV);部分液体通气组(PLV);联合组为PLV+雾化吸入伊洛前列素(iloprost)。分别监测各组治疗前后各时相点PaO2、PaCO2及肺静态顺应性(Cstat)、肺动脉平均压(pu lmonary arterial pressure,PAP)的变化。结果联合组PaO2从(104±16)mmHg升高到(236±38)mmHg(P<0.05),肺动脉平均压从(22±5)mmHg降低到(16±3)mmHg(P<0.05)。联合组PaO2的升高及PAP的降低优于CMV组和PLV组。结论部分液体通气联合雾化吸入伊洛前列素不仅对于改善ALI肺氧合功能优于单纯部分液体通气,还可减低部分液体通气对肺血流动力学的影响,降低肺动脉高压。Objective To observe the effectiveness of inhalation of aerosol iloprost during partial liquid ventilation （PLV） on gas exchange and pulmonary mechanics in oleic acid （OA） induced acute lung injury （ALI） rabbits. Methods Twenty-four healthy white rabbits were established into acute lung injury model induced by OA and randomly allocated to three groups respectively receiving conventioal mechanical ventilation （ CMV group）, CMV and partial liquid ventilation （ PLV ＋ CMV group）, combinated ventilation of CMV, PLV with inhalation of aerosol iloprost （ combined group）. The parameters such as PaO2, PaCO2, Cstat, pulmonary arterial pressure （PAP） were observed before ALI establishment and at 0, 1, 2, 3, 4 h after treatment. Results In combined group, PaO2 increased from （ 104 ＋ 16 ） mmHg to （ 236 ＋ 38 ） mmHg （ P 〈 0. 05 ）, PAP decreased from （22 ＋5） mmHg to （ 16 ＋3） mmHg （P 〈0. 05）, HR, MAP and CVP showed no significant changes after ventilation as compared with PLV ＋ CMV group. Conclusion This study demonstrated that inhalation of aerosol iloprost at partial liquid ventilation improved pulmonary oxygenation more than PLV alone in the acute lung injury model. Inhaled aerosol iloprost can effectively decrease pulmonary artery hypertension.

关 键 词：部分液体通气 全氟化碳 急性肺损伤 伊洛前列素 

分 类 号：R459.9[医药卫生—治疗学] R563[医药卫生—临床医学]