内毒素致家兔急性肺损伤时肺和肺外脏器的病理组织学变化及东莨菪碱和前列腺素E_1的保护作用  

Pathohistologic changes in lung and other organs in acute lung injury induced by endotoxin and protective action of scopolamine and prostaglandin E 1/

作　　者：黄念秋[1,2] 宋惠芳[1,2] 汪建新[1,2] 赵中苏 施毅[1,2] 李维华 

机构地区：[1]解放军总医院 [2]解放军三○四医院

出　　处：《中国危重病急救医学》1997年第6期326-329,共4页Chinese Critical Care Medicine

摘　　要：目的：了解内毒素血症时各脏器受损的病理组织学变化及东莨菪碱和前列腺素Ｅ１的保护作用。方法：大耳白兔５０只，随机分为５组：Ａ组为对照组；Ｂ组为内毒素致伤组（７００μｇ／ｋｇ）；Ｃ组、Ｄ组分别为内毒素致伤后东莨菪碱和前列腺素Ｅ１治疗组，Ｅ组为东莨菪碱和前列腺素Ｅ１联合治疗组。实验前及实验后０．５、２、４和６小时分别测血压和呼吸频率；实验后６．５小时放血处死动物，测肺毛细血管通透指数，同时取肺、心、脑、肝、肾、肾上腺和脾组织作光镜及电镜检查。结果：Ｂ组动物全部于实验后０．５小时出现休克和呼吸困难；６．５小时测得的肺毛细血管通透指数显著高于对照组，各脏器的病理组织学改变以肺最为明显且严重。各治疗组肺受损均轻于Ｂ组，其它脏器在实验后６．５小时的病理变化不明显。结论：内毒素休克时，肺是敏感且最早受损的脏器；东莨菪碱和前列腺素Ｅ１联合治疗组的疗效基本与两药单独治疗组相同。Objective:To explore the pathohistologic changes in lung and some organs due to endotoxemia and protective action of scopolamine and prostaglandin E 1(PGE 1).Methods:50 rabbits were divided into five groups randomly:control group (A),damaged by endotoxin 700 μg/kg (B),treated with scopolamine after injury (C),treated with PGE 1(D) and with scopolamine add to PGE 1 (E).Blood pressure,respiratory rate,PaO 2 and PaCO 2 were determined before and a half,two,four,six hours after experiment.In addition,rabbits were died by blood discharged at six and a half hours after experiment.The pulmonary capillary permeability indexes were measured and lung,heart,brain,kidney,adrenal grand and spleen were examined by light and electron microscope.Results:There were shock and dyspnea in all rabbits of group B,the pulmonary capillary permeability index was obvious higher than group A and the severity of damage in all treatment groups were slighter than group B.Otherwise,the pathohistologic change in lung was more obvious than other organs.Conclusions:The lung was an organ that most sensibility to endotoxic shock and it was damaged early.It could explain the high morbidity of ARDS in endotoxemia.

关 键 词：内毒素 肺损伤 急性 东莨菪碱 前列腺素E1 

分 类 号：R563.02[医药卫生—呼吸系统]