猪肺表面活性物质气管内给药对大鼠海水吸入性肺损伤的效果  

Therapeutic effects of intratracheal instillation of porcine pulmonary surfactant on seawater aspirationinduced lung injury in rats

作　　者：黄静霞[1] 孙瑜[2] 钟纪根[2] 邓小明[1] 卢建[2] 

机构地区：[1]第二军医大学长海医院麻醉科,上海市200433 [2]第二军医大学基础部病理生理教研室

出　　处：《中华麻醉学杂志》2007年第8期724-727,共4页Chinese Journal of Anesthesiology

基　　金：全军医药卫生十五科研项目（01NA145）;上海市科委重点基础项目（03JC14002）

摘　　要：目的评价猪肺表面活性物质（PPS）气管内给药对大鼠海水吸入性肺损伤的效果。方法健康SD大鼠加只，雌雄不拘，体重230～250g，制备大鼠海水吸入性肺损伤模型，随机分为5组，对照组（C组，n=6）不吸入海水，气管导管内滴入生理盐水4ml／kg；海水吸入性肺损伤组（ALI-SW组，n=10）和不同剂量PPS组（PPS100组、PPS150组、PPS200组，n=8）于海水吸入后30min，分别经气管导管内滴入生理盐水及PPS100、150、200mg／kg（容量均为4ml／kg）。于海水吸入前30min、吸入后30min及气管导管内滴入NS或PPS后1、2、4h记录呼吸频率（RR），并测定动脉血氧分压（PaO2）和动脉血二氧化碳分压（PaCO2），记录大鼠生存情况。检测肺系数（LI）和支气管肺泡灌洗液（BALF）中总蛋白（TP）浓度，并观察肺组织形态学及病理学。结果与C组比较，ALI-SW组RR升高、PaO2降低、LI和TP浓度升高（P〈0．05），PPS100组、PPS150组、PPS200差异无统计学意义（P〉0．05）。与ALI-SW组比较，PPS100组、PPS150组、PPS200组RR降低，PaO2升高，LI和TP浓度降低（P〈0．05），肺间质水肿减轻，肺泡结构清晰，肺泡内渗液较少。结论猪肺表面活性物质（100、150或200mg／kg）气管内给药可减轻大鼠海水吸人性肺损伤。Objective To assess the therapeutic effects of intratracheal instillation of porcine pulmonary surfactant （PPS） on lung injury induced by sea water aspiration. Methods Forty SD rats of both sexes weighing 230-250 g were randomly assigned to one of 5 groups ： group Ⅰ control （ n = 6） ; group Ⅱ seawater aspiration induced lung injury （LI n = 10）; group Ⅲ, Ⅳ, Ⅴ received intratracheal instillation of PPS 100 （Ⅲ）, 150 （Ⅳ） and 200 （ Ⅴ ） mg/kg at 30 rain after LI respectively. The animals were anesthetized with intraperitoneal 3% pontobarbitaf 30 mg/kg and tracheostomized. Spontaneous breathing was maintained. Sea water 2 ml/kg was instilled into the lungs via trachea twice at 2 rain interval in group Ⅱ , Ⅲ , Ⅳ and Ⅴ . Respiratory rate （RR） and arterial blood gases were measured before and after sea-water aspiration and at 1, 2 and 4 h after tracheal instillation of PPS or normal saline. Survival state was recorded. The animals were killed by exsanguination at 4 h after tracheal PPS instillation. The lungs were removed for microscopic examination and measurement of lung index （ wet lung weight/body weight） and the total protein concentration of broncho-alveolar lavage fluid （ BALF）. Results Sea water aspiration significantly increased RR and decreased PaO2 in group Ⅱ as compared with control group. The lung index and total protein concentration of BALF were significantly increased and histologic examination showed lung edema, alveolar atrophy and inflammatory ceil infiltration in group Ⅱ . Instillation of the 3 doses of PPS significantly attenuated the deleterious effects induced by sea-water aspiration. Conclusion Porcine pulmonary surfactant replacement has beneficial effects against lung injury induced by sea water aspiration in rats.

关 键 词：肺表面活性剂 插管法 气管内 海水 投药 吸入 呼吸窘迫综合征 成人 

分 类 号：R563[医药卫生—呼吸系统]