全氟化碳汽化吸入治疗兔海水淹溺型呼吸窘迫综合征的实验研究  

Effects of vaporized perfluorocarbon therapy on seawater respiratory distress syndrome in rabbit models

作　　者：赵晓巍[1] 张健鹏[1] 黄贤[1] 刘又宁[2] 

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

出　　处：《中华结核和呼吸杂志》2010年第3期169-173,共5页Chinese Journal of Tuberculosis and Respiratory Diseases

基　　金：全军十一五攻关课题基金资助项目（06G103）;解放军总医院创新课题基金资助项目（ZY04）;武警总医院课题资助项目

摘　　要：目的制作海水淹溺型呼吸窘迫综合征（SW-RDS）兔模型，观察全氟化碳（PFC）汽化吸入对SW—RDS的治疗作用。方法将27只健康雌性新西兰兔按随机数字表法分为常规通气组（CMV组）、PFC汽化吸入组（PFC组）和对照组，每组8只，余3只为空白对照。采用人工海水2ml／k气管内注入建立动物模型。CMV组模型建立成功后采用常规通气治疗6h后处死（潮气量为8ml／kg）；PFC组模型建立成功后先汽化吸入PFC（6～7ml·kg^-1·h^-1）2h，后调整为常规通气继续治疗4h后处死；对照组动物模型成功后不予治疗，观察自然死亡时间。将处死动物右肺游离并结扎，取右肺下叶组织2—3块制备病理切片，观察肺组织病理结构改变。另取3只动物麻醉后直接处死观察正常兔肺组织结构。结果SW—RDS兔模型建立成功后其氧合指数和呼吸力学指标明显恶化，应用常规通气治疗上述指标无改善，肺组织损伤继续加重，PFC组在PFC汽化吸入治疗30min后氧合指数（1584-65）明显高于CMV组（74±12，F：26，P〈0．05）；肺顺应性为（2±1）mmHg／cmH20（1mmHg=0．133kPa，1cmH20=0．098kPa），高于CMV组的（1±0）mmHg／cmH20（F=20，P〈0．05）；肺组织病理评分（6．9±1．6）低于CMV组（9．8±1．3）（χ2=22，P〈0．05），肺泡不同程度复张。此外，在停止PFC汽化后，氧合改善作用仍能维持4h[PFC为（253±96）mmHg，CMV组为（78±19）mmHg，F=15，P〈0．05]。结论PFC汽化吸入不仅可改善SW—RDS兔的氧合状态并可维持一定的时间，同时可改善肺顺应性，减轻肺组织损伤。Objective To investigate the effects of vaporized perfluorocarbon therapy on pulmonary gas exchange and lung compliance in seawater respiratory distress syndrome rabbit models. Methods After induction of seawater respiratory distress syndrome by means of intratracheal injection of seawater, 24 female New Zealand rabbits were randomly divided into 3 groups ： （1）CMV group （ n = 8 ） ： Animals were ventilated with equal tidal volumes of 8 ml/kg during gas ventilation for 6 h. （2）PFC group （n = 8） ： For the first 2 h, animals received vaporized PFC with volumes of 6 - 7 ml·kg^-1·h^-1, followed by gas ventilation for 4 h. （3）control group （n = 8 ） ： No ventilation was administered. Physiological and blood gas data were compared among the 3 groups by analysis of variance. The right lung of each animalwas cut into 2 or 3 slides which were fixed with 10% buffered formalin for pathologieal evaluation. Results After lung injury, the measurements of lung compliance and oxygenation became significantly worse. After vaporized PFC for 30 rain, lung compliance and oxygenation improved significantly as compared to the CMV group [ （2 ± 1 ）mm Hg/cm H20 vs （1 ±0） mm Hg/cm H20（ 1 mm Hg = 0. 133 kPa, 1 cm H2O= 0. 098 kPa）, F = 20,P 〈 0.05; （158 ± 65 ）mm Hg vs （74± 12）mm Hg, F=26, P 〈 0.05 ]. After PFC inhalation, the improvement of oxygenation in PFC group lasted for 4 h [ （253 ＋96） mm Hg vs （78 ± 19） mm Hg, F = 15, P 〈 0. 05 ]. The lung injury score was also decreased in the PFC group compared to the CMV group（6.9± 1.6 vs 9.8 ±1.3, χ2 =22, P〈0. 05）.All animals in the control group died in 15 min without ventilation. Conclusion Vaporized PFC improved oxygenation and lung compliance and attenuated lung injury in a rat model of seawater induced respiratory distress syndrome.

关 键 词：呼吸窘迫综合征 成人 氟碳化合物 溺水 海水 

分 类 号：R563.8[医药卫生—呼吸系统]