全氟化碳汽化吸入对急性肺损伤兔多脏器病理组织学的影响  

Effects of Vaporized Perfluorocarbon Inhalation on Histopathology of Lung and Extra-Pulmonary Organs in Rabbits with Acute Lung Injury

作　　者：韩丙超[1] 解立新[1] 赵晓巍[2] 黄贤[2] 

机构地区：[1]解放军总医院呼吸内科,北京100853 [2]武警总医院呼吸内科,北京100039

出　　处：《中国呼吸与危重监护杂志》2009年第2期171-175,共5页Chinese Journal of Respiratory and Critical Care Medicine

基　　金：军队“十一五”专项课题;解放军总医院创新课题(编号:062Y04)

摘　　要：目的通过全氟化碳(PFC)汽化吸入治疗ALI兔模型,探讨全氟化碳汽化吸入对ALI动物肺、小肠、肝、肾病理组织学的影响及意义。方法将18只新西兰兔随机分为三组:常规通气组(CMV组)、PFC汽化吸入组(PFC组)及对照组。将兔气管切开,插管连接呼吸机进行机械通气,通过人工海水气管内注入制作ALI模型后,CMV组给予常规通气6 h,PFC组给予汽化吸入PFC治疗2 h后调整为常规通气观察4 h,对照组撤除呼吸机。实验结束后将各组动物肺、小肠、肝、肾进行固定、包埋和切片,光镜下进行组织病理学评分。结果对照组兔在撤离呼吸机15 min内全部死亡。PFC组氧合指数在治疗和后续观察期内持续改善,明显高于CMV组。与CMV组比较,汽化吸入PFC能明显减轻肺组织的病理损伤(5.283±0.679比9.833±0.753,P<0.05);肝(0.683±0.133比1.100±0.580)、肾(0.767±0.484比0.883±0.240)和小肠(0.500±0.190比0.750±0.521)的病理损伤虽然呈现出减轻的趋势,但差异无统计学意义。结论汽化吸入PFC在改善氧合的同时,能明显减轻肺组织的病理损伤,但不能证实对肺外器官有明显保护作用。Objective To investigate the effects of vaporized perfluorocarbon （PFC） inhalation on histopathology of lung, small intestine, liver and kidney of acute lung-injured rabbits. Methods Eighteen New Zealand rabbits were randomly divided into 3 groups, ie. a conventional mechanical ventilation （CMV） group, a PFC group, and a control group. The rabbits were mechanical ventilated and intratracheally infused artificial seawater to induce acute lung injury. After ALI was established （PaO2/FiO2 〈 200 mmHg ）, the CMV group received CMV for 6 hours. The PFC group received PFC inhalation for 2 hours, and followed by CMV for 4 hours. And the control group was weaned from ventilation. Then they were sacrificed for histopathological measurement of lung, small intestine,liver and kidney. Results The rabbits in the control group died in 15 minutes after discontinuation of ventilation. Vaporized PFC inhalation can obviously improve oxygenation and attenuate the damage of the lung in contrast to CMV. Mild improvement was observed in small intestine, liver and kidney after vaporized PFC inhalation, but without statistical significance. Conclusion Vaporized PFC inhalation can improve oxygenation and attenuate lung injury in histopathology, but have no apparent protective effects on extra-pulmonary organs.

关 键 词：全氟化碳 急性肺损伤 机械通气 病理 多脏器损伤 

分 类 号：R563.8[医药卫生—呼吸系统]