体外膜肺氧合对急性肺损伤治疗的实验研究  

Treatment of extracorporeal membrane oxygenation on acute lung injury

作　　者：陈燕桦[1] 张炳东[1] 梁东科[1] 何芳[1] 梁蓓薇[1] 

机构地区：[1]广西医科大学第一附属医院心血管病研究所手术麻醉室,广西南宁530021

出　　处：《中国现代医学杂志》2011年第19期2215-2218,共4页China Journal of Modern Medicine

基　　金：广西自然科学基金(No:0640132)

摘　　要：目的探讨体外膜肺氧合(ECMO)对内毒素(LPS)诱导大鼠急性肺损伤(ALI)的治疗效果。方法 LPS静脉注射复制大鼠急性肺损伤模型。40只健康雄性SD大鼠随机分为4组:LPS组(L组:静脉注射LPS)、对照组(C组:静脉注射生理盐水)、机械通气治疗组(LV组:ALI模型制备成功后,行机械通气2h)、ECMO治疗组(LE组:ALI模型制备成功后,行机械通气及ECMO治疗2h),每组10只。实验结束时,将4组大鼠在无菌条件下开胸取出两肺,取左肺下叶同一部位小块肺组织,测定肺湿/干质量比值;取右肺下叶同一部位两小块组织,分别用于HE染色观察肺组织的病理改变及作TUNEL法观察细胞凋亡数。结果与C组比较,L组的肺组织湿/干质量比值增加(P<0.01);与L组比较,LV组、LE组的肺组织湿/干质量比值减少(P<0.05);LV组和LE组的肺组织湿/干质量比值差异无显著性(P>0.05)。与C组比较,L组、LV组与LE组的肺组织凋亡指数升高(P<0.01);与L组比较,LE组的凋亡指数下降(P<0.05),L组和LV组的肺组织凋亡指数差异无显著性(P>0.05);与LV组比较,LE组的凋亡指数下降(P<0.05)。凋亡指数分级为:C组0级,L组3级,LV组3级,LE组2级。光镜下观察发现L组的肺组织损伤及细胞凋亡程度最为严重,LV组次之,而LE组较LV组减轻。结论体外膜肺氧合对内毒素诱导大鼠急性肺损伤有治疗作用。【Objective】 To investigate the effects of extracorporeal membrane oxygenation on acute lung injury induced by lipopolysaccharide in rats.【Methods】 Rats were injected LPS.Forty male SD rats were randomly divided into four groups（n =10）： LPS group（LPS group received LPS 3mg/kg i.v）;sham operation control group（control group received only normal saline）;mechanical ventilation group（2 hours of mechanical ventilation were performed after succeeding duplicating the rat ALI model）;ECMO group（2 hours of ECMO and mechanical ventilation were performed after succeeding duplicating the rat ALI model）.At the end of the experiment,the lungs were removed under the aseptic condition from rats of the four groups,and two scrap lung organizations were taken under the identical spot of the right lung lower lobe.Pathological changes of lung tissue for HE staining was observed under the light microscope,the other lung tissue＇s cell apoptosis was detected by TUNEL assay.A scrap organization of the left lung lower lobe was used for determining the wet/dry lung weight ratio.【Results】 The wet/dry lung weight ratio was significantly increased in LPS group compared with control group（P 0.01）,there were no statistically significant difference between mechanical ventilation group and ECMO group.The lung apoptotic index was significantly increased in other groups compared with control group（P 0.01）;The lung apoptotic index was significantly decreased in LE group compared with LPS group（P 0.05）,there were no statistically significant difference between mechanical ventilation group and LPS group（P 0.05）;The lung apoptotic index was decreased in ECMO group compared with mechanical ventilation group（P 0.05）.The lung apoptotic index was 0 grades in control group,3 grades in L group,3 grades in LV group,2 grades in LE group.Light microscopic findings found that the most serious lung injury case was in L group,LV group was better than L group,LE was better than LV group,C group was normal.【Con

关 键 词：体外膜肺氧合 急性肺损伤 细胞凋亡 

分 类 号：R563.9[医药卫生—呼吸系统] R654.1[医药卫生—内科学]