甲泼尼龙预处理对兔复张性肺水肿肺通透性和肺泡表面活性物质的影响  

Effect of methylprednisolone pretreatment on pulmonary permeability and dipalmitoylphosphatidylcholine content in rabbits with reexpansion pulmonary edema

作　　者：柯毓文[1] 古妙宁[1] 刘绮虹[1] 徐建设[1] 万山河[1] 

机构地区：[1]南方医科大学南方医院麻醉科,广东广州510515

出　　处：《南方医科大学学报》2011年第6期1090-1092,共3页Journal of Southern Medical University

基　　金：南方医院院长基金(2009A001)

摘　　要：目的研究静脉注射甲泼尼龙预处理对兔复张性肺水肿肺通透性和肺泡表面活性物质的影响。方法 21只雄性新西兰大耳兔随机分为3组:C组为空白对照组,R组为复张性肺水肿组,R+M组为复张性肺水肿+甲泼尼龙预处理组。按Sakao改良方法建立兔复张性肺水肿模型,分别在肺复张前20min静脉注射甲泼尼龙3mg/kg或生理盐水2.0ml/kg对动物进行预处理。于复张后4h收集支气管肺泡灌洗液(BALF)及抽取动脉血样,测定总蛋白和二棕榈酰磷脂酰胆碱(DP-PC)含量,并计算肺通透性指数。结果 BALF总蛋白含量R组最高,与C组及R+M组相比差异有统计学意义(P<0.05)。肺通透性指数比较,C组最低,与R组有统计学差异(P<0.05),但与R+M组比较无统计学差异。BALF中DPPC含量C组最高,且与其余两组比较有统计学意义(P<0.05),R+M组含量高于R组(P<0.05)。结论甲泼尼龙3mg/kg预处理能降低复张性肺水肿兔肺的蛋白漏出,降低肺通透性指数,可提高复张性肺水肿兔肺的肺泡表面活性物质含量,改善肺通透性。Objective To investigate the effects of methylprednisolone pretreatment on pulmonary lung permeability index and the content of the pulmonary surfactant dipalmitoylphosphatidylcholine （DPPC） in a rabbit model of reexpansion pulmonary edema. Methods Twenty-one male New Zealand white rabbits were randomly divided into control group, reexpansion, and reexpansion＋methylprednisolone pretreatment groups. The rabbit model of reexpansion pulmonary edema was established using Sakao’s method. A bolus dosage of methylprednisolone （3 mg/kg） in reexpansion＋methylprednisolone group group or 2.0 ml/kg normal saline in the other two groups was administered intravenously 20 min before reexpansion pulmonary edema. Bronchoalveolar lavage fluid （BALF） and arterial blood samples were collected for measurement of the total protein （TP） and DPPC contents 4 h after reexpansion, and the pulmonary permeability index was calculated. Results The pulmonary permeability index in methylprednisolone pretreatment group was significantly lower than that in the reexpansion group （0.007±0.002 vs 0.177±0.004, P〈0.05）. Methylprednisolone pretreatment significantly increased DPPC concentration in the BALF as compared with saline treatment in the reexpansion group （61.815±28.307 vs 101.955±24.544 μg/ml, P〈0.05）. Conclusion Methylprednisolone pretreatment can increase pulmonary surfactant content and improve pulmonary permeability in the rabbit model of reexpansion pulmonary edema

关 键 词：复张性肺水肿 甲泼尼龙 肺通透性指数 支气管肺泡灌洗液 二棕榈酰磷脂酰胆碱 

分 类 号：R563[医药卫生—呼吸系统]