前列腺素E_1对稀盐酸吸入性急性肺损伤的保护作用  

Effect of Prostaglandin E_1 on Lung Protection Following Dilute Hydrochloric Acid Aspiration

作　　者：白浪[1] 刘建军[2] 贺伯明[2] 薛张纲[1] 蒋豪[1] 

机构地区：[1]复旦大学附属中山医院麻醉科,上海200032 [2]复旦大学附属中山医院消化内科,上海200032

出　　处：《复旦学报（医学版）》2001年第2期103-106,共4页Fudan University Journal of Medical Sciences

基　　金：上海市医学领先专业科研基金!(9930 2 7)资助项目

摘　　要：目的　研究前列腺素E1(PGE1)能否阻止酸吸入后急性肺损伤 (ALI)的发展。方法　 2 0只新西兰兔在稀HCl滴入后随机分成两组 :(1)损伤组在酸滴入后维持机械通气 ,未做其他治疗 ;(2 )治疗组在酸滴入后即刻缓慢静注PGE1并维持。在基础状态及酸滴入后记录血气 ,动物处死后测定右肺的湿干比 (W /D)值及测定右肺支气管肺泡灌洗液 (BALF)中总蛋白 (TP)及TNF α ,IL 1β和IL 8的水平 ,并作肺组织形态学观察。 结果　治疗组在酸滴入后 paO2 显著高于损伤组 ;右肺W /D、TP及TNF α、IL 1β和IL 8的水平显著低于损伤组。损伤组右肺呈弥漫性炎性损伤 ,而治疗组则呈局灶性 ,且其病理损伤程度较损伤组明显减轻。结论　①酸吸入后即刻应用PGE1可减轻ALI的范围和严重程度 ;②PGE1可通过调节肺内炎性细胞释放TNF α、IL 1β和ILPurpose: To study the effect of prostaglandin E1 (PGE 1) on blocking development of acute lung injury (ALI) induced by acid aspiration. Methods: Twenty rabbits were injected intrabronchialy with HCl and divided randomly into 2 groups: injury group were maintained with mechanical ventilation only and therapy group were administered a dose following a continuous administration of PGE1 after acid instillation. Blood gas as well as wet/dry weight ratio(W/D) of right lung, total proteins (TP), TNF-α, IL-1β and IL-8 level of right bronchoalveolar lavage fluid (BALF) were measured. Lung histology was examined. Results: Values of blood gas in therapy group were much better than in injury group. W/D,TP, TNF-α, IL-1β and IL-8 level were less in therapy group significantly. Compared right lungs in two groups, congestive and edematous foci was localized in therapy group on gross inspection, and injury was lessened in therapy group. Conclusions: PGE1 administration could lessen severity of ALI induced by acid aspiration. PGE1 protects lungs by means of inhibiting the capacity of inflammatory cells in lungs to release inflammatory mediators such as TNF-α, IL-1β and IL-8.

关 键 词：急性肺损伤 酸吸入 前列腺素E1 细胞因子 稀盐酸 ARDS ALI 

分 类 号：R563.05[医药卫生—呼吸系统]