前列腺素E1对急性肺损伤兔微循环灌注的影响  

Effect of prostaglandin E_1 on microcirculation during acute lung injury induced by oleic acid in rabbits

作　　者：张延卓[1] 李文志[1] 李洪波[1] 宋春雨[1] 潘鹏[1] 

机构地区：[1]哈尔滨医科大学附属第二医院麻醉科,150086

出　　处：《中华麻醉学杂志》2007年第12期1122-1125,共4页Chinese Journal of Anesthesiology

摘　　要：目的探讨前列腺素E1（PGE1）对急性肺损伤（ALI）兔微循环灌注的影响。方法健康家兔24只,体重2.6～3.2kg,随机分为3组：对照组（C组）、ALI组和PGE1治疗组（PGE组）,每组8只。麻醉稳定后15min（T0）,ALI组和PGE组静脉注射油酸0.015ml/kg制备兔ALI模型,模型制备成功后（T1）PGE组静脉输注PGE1 30ng·kg^-1·min^-1,C组和ALI组静脉注射等容量生理盐水,分别于T0、T1及模型制备成功后30min（T1）、60min（T3）、90min（T4）、120min（T5）和150min（T6）时测定平均动脉压（MAP）、平均肺动脉压（MPAP）、气道峰压（PIP）、动脉血氧分压（PaO2）、动脉血二氧化碳分压（PaCO2）及肺、肠系膜微循环的血流量;记录支气管肺泡灌洗液（BALF）中中性粒细胞（PMN）及总细胞计数,计算肺湿/干重比（W/D）,行肺组织病理学检查。结果与C组比较,ALI组和PGE组T1-6时PaO2降低,MPAP及PIP升高,肠系膜微循环血流量降低,BALF中PMN百分比和肺W/D升高（P〈0.05）,ALI组T3-6时肺微循环血流量降低（P〈0.05）;与ALI组比较,PGE组T3-6时PaO2升高,PIP降低,肺微循环血流量增加,T5,6时MPAP降低,T4-6时肠系膜微循环血流量增加,BALF中PMN百分比和肺W/D降低（P〈0.05）。ALI组支气管和肺泡腔内可见大量炎性渗出物和红细胞;PGE组肺泡腔内的炎性细胞相对减少,未见红细胞。结论静脉输注PGE1 30ng·kg^1-·min^-1可增加油酸致兔急性肺损伤时肺和肠系膜微循环血流量,改善肺微循环灌注,减轻肺损伤。Objective To investigate the effect of prostaglandin E1 on the microcirculation during acute lung injury （ALI） induced by oleic acid.Methods Twenty-four healthy male rabbits weighing 2.6-3.2 kg were randomly divided into 3 groups （n=8 each）;groupⅠcontrol （C）;groupⅡALI and groupⅢALI＋PGE.The animals were anesthetized with 1% pentobarbital sodium 30 ml/kg,tracheostomized and mechanically ventilated with 100% O2.PaCO2 was maintained at 38-42 mm Hg.The chest and abdomen were opened and the heart and small intestine mesentery were exposed.Pulmonary artery was cannulated for MPAP monitoring.After 15 min stabilization （T0） oleic acid 0.015 ml/kg was injected iv in groupⅡandⅢ.ALI was considered established when PaO2〈40 kPa （PaO2/FiO2〈300） （T1）.PGE1 was then continuously infused iv at 30 ng·kg^-1·min^-1.MAP, MPAP,PIP （peak inspiratory airway pressure） and lung and mesentery blood flow （measured with laser Doppler flowmeter） at T0,T1 and at 30,60,90,120 and 150 min after ALI was established （T2-T6）.The animals were killed at T6 by exsanguination and the lungs were removed for determination of W/D lung weight ratio and microscopic examination.The right lung was lavaged and bronchoalveolar lavage fluid （BALF） was collected for determination of total number of cells and the percentage of PMN.Results PaO2,the pulmonary and mesentery blood flow were significantly decreased while MPAP,PIP,the percentage of PMN in BALF and W/D ratio were significantly increased during ALI as compared with the baseline before ALI and control group.PGE1 intravenous infusion during ALI significantly ameliorated the above-mentioned ALI-induced changes.The lung damage was severer in ALI group than PGE group （Ⅲ）.Conclusion Intravenous PGE1 infusion （30 ng·kg^-1·min^-1） can ameliorate the decrease in lung and mesentery microcirculation during ALI induced by oleic acid.

关 键 词：前列地尔 呼吸窘迫综合征 成人 微循环 

分 类 号：R686[医药卫生—骨科学]