单侧肺滴入酸后急性肺损伤的研究  

Study on acute lung injury induced by acid inhalation to unilateral lung

作　　者：白浪[1] 薛张纲[1] 蒋豪[1] 

机构地区：[1]上海医科大学附属中山医院麻醉科,上海200032

出　　处：《中国危重病急救医学》2000年第9期533-536,共4页Chinese Critical Care Medicine

基　　金：上海市医学领先专业科研基金资助项目!(9930 27)

摘　　要：目的 :观察酸滴入侧的急性肺损伤 (AL I)的形成及对侧肺有无损伤形成。方法 :18只新西兰兔随机分为生理盐水 (NS)滴入对照组和盐酸滴入损伤组。以向右肺内滴入 NS或 HCl后的血气、气道压力、动静态顺应性、肺湿 /干比 (W/ D)和支气管肺泡灌洗液 (BAL F)中总蛋白 (TP)、总磷脂 (TPL )、饱和磷脂占总磷脂比(DSPC/ TPL )及肺组织形态学来判断有无 AL I及其严重程度。结果 :损伤组在酸滴入后 Pa O2 较基础值和对照组显著下降而 Pa CO2 显著上升 ,损伤组气道压力显著高于基础值和对照组。损伤组右肺的 W/ D和 TP均高于对照组右肺 ,而 TPL 和 DSPC/ TPL 则低于对照组 ,2组左肺的上述各参数相比均无显著性差异。损伤组右肺病理损伤明显 ,而损伤组左肺和对照组双肺镜下未见异常。结论 :(1)酸滴入后肺内可形成弥漫性的以蛋白通透性肺水肿为特征的急性炎性损伤。 (2 )单侧肺滴入酸未导致对侧肺形成 ALObjective:To investigate the acute lung injury (ALI) induced by acid inhalation and to compare the incidence of ALI between unilateral lung and contralateral lung.Methods:Eighteen New Zealand rabbits were randomly divided into two groups which were control group ( n =8) and injury group ( n =10).The animals were anesthetized and mechanically ventilated.Normal saline or HCl was instilled into the right lung in both groups.Blood gas analysis was performed accordingly and the airway pressure,dynamic and static compliance,wetdry weight ratio(W/D) of lung tissues were monitored.Total proteins (TP),total phospholipids (TPL) and desaturated phosphatidylcholine (DSPC) of bronchoalveolar lavage fluid (BALF) were assayed.After the animals were sacrificed,pathological changes of lung tissues were examined.Results:Decrease in PaO 2 and increase in PaCO 2 were observed in injury group as compared with those of baseline and control.The W/D of the right lung and TP in BALF of the right lung in injury group significantly increased while TPL and DSPC/TPL of the right BALF significantly decreased.These differences were not seen in the left lung in two groups.All right lungs in the injury group showed obvious damage morphologically while the left lungs in injury group and lungs on both sides in control group were normal.Conclusions:①ALI induced by acid instillation was characterized by widespread protein rich edema in lung tissues.②Instillation of acid to unilateral lung does not result in ALI of the contralateral lung.

关 键 词：急性肺损伤 酸滴入 单侧肺 麻醉 

分 类 号：R363[医药卫生—病理学]