油酸肺损伤后肺泡液体清除功能的变化及其意义  

Change of alveolar liquid clearance capacity following acute lung injury induced by oleic acid

作　　者：陶军[1] 刘桥义[1] 杨天德[1] 史忠[1] 杨玉萍[1] 李永旺[1] 

机构地区：[1]第三军医大学新桥医院麻醉科,重庆400037

出　　处：《中华麻醉学杂志》2000年第1期37-39,共3页Chinese Journal of Anesthesiology

摘　　要：目的　观察大鼠油酸型肺损伤后肺泡上皮液体清除功能的变化。方法　Wistar大鼠48只 ,随机分为正常对照组 (C组 )、油酸致伤组 (I组 )、阿咪洛利组 (A组 )、哇巴因组 (O组 )、阿咪洛利加哇巴因组 (AO组 )和特普他林组 (T组 )。经股静脉注入油酸 0 .2 5ml.kg-1诱导油酸型肺损伤动物模型 ,2 4h后C组和I组经气管滴注 5 %白蛋白溶液 5ml.kg-1。A组和O组气管内分别滴注阿咪洛利 (2× 10 -3 mol/L)和哇巴因 (5× 10 -4 mol/L)溶液 5ml.kg-1;AO组则滴注阿咪洛利和哇巴因混合液 ;T组滴注特普他林溶液 (10 -4 mol/L) 5ml.kg-1。注药后 1h测定肺泡内液体清除率 (ALC)、总肺水量 (TLW)、肺血管外肺水量 (EVLW )和动脉血气。结果　与C组相比 ,I组出现严重的低氧血症 ,ALC降低 49.2 % ,TLW和EVLW明显增加 (P <0 .0 1) ;A组和O组ALC较I组进一步降低 ,TLW和EVLW进一步增加 (P <0 .0 5 ) ;AO组ALC则降至最低点 ,TLW和EVLW升至最高点。而T组ALC较致伤组升高 6 3.7% ,TLW和EVLW显著减少 (P <0 .0 1) ,低氧血症明显改善。ALC与TLW和EVLW之间呈显著负相关。Objective To explore the change of alveolar epithelial liquid clearance capacity in lung edema following acute lung injury induced by oleic acid.Methods Forty-eight Wistar rats were randomly divided into 6 groups: the control(C), injury(I), amiloride(A), ouabain(O),amiloride plus ouabain(AO), and terbutaline(T) groups. Acute lung injury was induced with intravenous oleic acid 0.25 mlkg -1. 24h after injury, 5% albumin solution (5 ml·kg -1) was delivered into both lungs via the trachea in C and I groups. In A, O, AO and T groups, amiloride (2×10 -3 mol/L),ouabain (5×10 -4 mol/L), amiloride (2×10 -3mol/L) and ouabain (5×10 -4 mol/L)mixture and terbutaline(10 -4 mol/L),added respectively to the albumine solution,at 5ml.kg -1 were administered intratracheally to both lungs separately. One hour later, the alveolar liquid clearance rate(ALC), total lung water content(TLW), extravascular lung water content(EVLW) and arterial blood gases were measured.Results As compared with those in C group, severe hypoxemia, hypercapnia and acidosis appeared, ALC was reduced by 49.2% ,TLW and EVLW markedly increased in I group(P<0.01).Compared with those in I group, ALC decreased much more , TLW and EVLW further rose in A,O and AO groups(P<0.05 or 0.01),but ALC increased by approximately 63.7%, TLW and EVLW greatly decreased(P<0.01), and hypoxemia was improved in T group. A significant negative correlation was found between TLW or EVLW and ALC.Conclusions The alveolar epithelial liquid clearance capacity may be play an important role in the pathogenesis of lung edema following acute lung injury.

关 键 词：肺损伤 肺水肿 液体转运 油酸 

分 类 号：R364[医药卫生—病理学]