低温对大鼠内毒素性ARDS的有利影响  

The Favorable Effect of Hypothermia on Acute Respiratory Distress Syndrome Induced by Lipopolysaccharide in Rats

作　　者：陈肖[1] 祝建中[2] 顾卫东[3] 彭玉梅[1] 方明[1] 曾因明[4] 丁浩中[3] 

机构地区：[1]江苏省无锡市第三人民医院麻醉科,214041 [2]江苏省无锡市第三人民医院外科,214041 [3]无锡市第四人民医院麻醉科 [4]徐州医学院江苏省麻醉学研究所

出　　处：《中国微循环》2006年第1期14-17,i0002,共5页Journal of Chinese Microcirculation

基　　金：江苏省科技厅资助项目(BS2000024);无锡市科技厅资助项目(HS20030008)

摘　　要：目的 观察32．5—33％低温对大鼠内毒素性急性呼吸窘迫综合征（ARDS）的有利影响。方法 采用大鼠腹腔注射内毒素（LPS），16h后再行气管内滴注LPS的方法建立ARDS模型。34只雄性SD大鼠被随机分为4组：生理盐水常温组（NN）、生理盐水低温组（NH）、ARDS低温组（AH）、ARDS常温组（AN）。观察气管内滴注前（基础值）、达到ARDS时、ARDS后1、2、3各时间点动脉血氧分压／吸入氧浓度（PaO2／FiO2）、平均动脉压（MAP）、中心静脉压（CVP）和二氧化碳分压（PaCO2）的变化。ARDS后3h处死动物，开胸取右肺上叶作肺形态学观察，取左肺计算湿重／干重（W／D）比值，并采用溴甲酚绿法测定支气管肺泡灌洗液（BALF）中白蛋白的含量。结果 AN、AH组滴注LPS后PaO2／FiO2比值逐渐下降，在ARDS时、ARDS后1、2、3h较基础值和NN组相应时间点相比降低非常明显（P〈0．01）。AN组PaCO2在ARDS时、ARDS后1、2、3h较基础值升高非常显著（P〈0．01）。AH组PaCO2在ARDS时、ARDS后1、2h与基础值和NN组相比升高显著（P〈0．05）；在ARDS后3h与基础值及NN组相比无显著差异（P〉0．05），但与AN组相比明显降低（P〈0．05）。AH组BALF中白蛋白含量、左肺W／D较AN组降低明显（P〈0．05）；且与NN组相比无统计学差异（P〉0．05）。肺组织病理显示AH组肺泡壁充血增厚，肺间质和肺泡腔内炎性细胞浸润均较AN组减轻。结论 低温对大鼠内毒素性ARDS有一定的有利影响。Objective To study the favorable effect of hypothermia on ARDS induced by lipopolysaccharide in rats. Methods A rat model of acute respiratory distress syndrome（ARDS） was established by intratracheal instillation of lipopolysaecharide at 16 h after LPS intraperitoneal administration. Thirty-four male Sprague Dawley rats were randomly divided into four groups. NS ＋ Normalthermia group（ NN）, NS ＋ Hypothermia group（NH）, ARDS ＋ Hypothermia group（AH）, ARDS ＋ Normalthermia group（AN）. The changes of PaO2/FiO2, MAP, CVP and PaCO2 were observed at basic situation, onset of ARDS and 1 h, 2 h, 3 h after ARDS. At 3 h after ARDS, rats were killed by hemorrhage from carotid artery. Histomorphology of superior lobe of right lung tissue was examined, and the wet weight / dry weight ratio of left lung was measured. Lung lavage was performed, the albumin contents in BALF were measured using spectrophotography. Results Compared with the basic values and the NN group, oxygernation index in the AH and AN groups significantly decreased at the time of ARDS and 1h, 2h, 3h after ARDS （P〈0.01）, but there were no significant differences between the two groups （P 〉0.05）. At the time of 3 h after ARDS, PaCO2 in the All group was significantly lower than that in the AN group （ P 〈 0.05）, and compared with the NN group, there was no significant difference （P 〉0.05）. However, at the time of ARDS and 1 h, 2 h after ARDS, PaCO2 in the AH group was markedly higher than the base values and that in the NN group （P 〈 0. 05）, but there were no significant differences at the time of 3 h after ARDS （P 〉 0. 05）. No significant differences were noted in MAP and CVP among the four groups. In the AH group, the albumin contents in BALF and the lung wet weight/dry weight ratio were much lower than those in the AN group（P 〈 0. 01）, but there were no significant differences compared with the NN group（P 〉 0. 05）. A lot of pint hemorrhagic spots, in the AH group, the histological index of

关 键 词：低温 内毒素 ARDS 

分 类 号：R563.8[医药卫生—呼吸系统] R852.52[医药卫生—内科学]