外源性肺泡表面活性物质对重度烧冲复合伤大鼠急性肺损伤的治疗作用  

Effects of exogenous pulmonary surfactant on acute lung injury in rats with severe burn-blast combined injury

作　　者：李百玲[1] 柴家科[2] 胡泉[2] 张旭龙[2] 张东海[2] 马丽[2] 郁永辉[2] 刘玲英[2] 

机构地区：[1]天津医科大学研究生院,300070 [2]解放军总医院第一附属医院烧伤整形科

出　　处：《中华医学杂志》2015年第2期133-137,共5页National Medical Journal of China

基　　金：军事医学创新专项计划（13CXZ026）

摘　　要：目的 观察外源性肺泡表面活性物质对重度烧冲复合伤大鼠急性肺损伤的治疗作用.方法 健康雄性SD大鼠180只,用随机数表法分为假伤组、治疗组、对照组各60只,每组致伤前0h及伤后6、24、48、72 h共5个观察时相点各12只.进行如下处理：（1）假伤组：脱毛12 h后,以3％戊巴比妥钠30 mg/kg腹腔内注射麻醉,将背部脱毛区域置入37℃水中持续12s;（2）治疗组：参照既往大鼠重度烧冲复合伤模型,致伤后立即经气管插管滴注外源性肺泡表面活性物质即猪肺磷脂注射液2 ml/kg;（3）对照组：参照既往大鼠重度烧冲复合伤模型,致伤后立即经气管插管滴注等量的生理盐水2 ml/kg.分别于致伤前0h及伤后6、24、48、72 h监测大鼠动脉血氧分压（PaO2）及二氧化碳分压（PaCO2）,测定各组大鼠肺功能,留取肺组织,行病理观察.结果 除去实验过程中的死亡损耗后,最终3组5个时相点分别均衡纳入8只大鼠进行统计学分析.PaO2：对照组6、24、48、72 h各时相点均显著低于假伤组[（69.55±5.11）、（62.05±6.54）、（53.24±7.65）、（50.00±7.45）比（93.75±3.41）、（94.25±2.19）、（93.63±2.33）、（93.25±1.83） mmHg（1 mmHg =0.133 kPa）,均P＜0.05];治疗组6h接近假伤组[（92.63±3.74）比（93.75±3.41）mmHg,P=0.594];对照组6h时即降至70 mmHg左右,随后逐渐下降,而治疗组各时相点均显著高于对照组[（92.63±3.74）、（87.50±3.34）、（78.75±3.11）、（71.38±3.74）比（69.55±5.11）、（62.05±6.54）、（53.24±7.65）、（50.00±7.45） mmHg,均P＜0.05].PaCO2：治疗组在6、24、48 h显著低于对照组[（45.50±6.79）、（49.38±7.52）、（54.13±4.82）比（53.25±2.76）、（59.50±6.61）、（63.60±7.33） mmHg,均P＜0.05],72 h时而治疗组与对照组均显著高于假伤组[（59.63±6.87）、（68.88±6.85）比（36.38±1.85） mmHg,均P＜0.05],而治疗组与对照组差异无统计学意义（P =0.051）.�Objective To observe the therapeutic effects of exogenous pulmonary surfactant （PS） on acute lung injury induced by severe burn-blast combined injury in a rat model.Methods A total of 180 adult male SD rats were randomly divided into 3 groups of sham,treatment and control （n =60 each）.Severe burn-blast combined injury was induced by inflicting rats with a moderate blast injury and a full-thickness burn injury of 25% total body surface area.The treatment and control groups received exogenous PS （2 ml/kg） and saline （2 ml/kg） by trachea respectively.At the time points of 0,6,24,48 and 72 h,12 rats per timepoint in each group underwent PaO2,PaCO2 and pulmonary function tests respectively.And they were then sacrificed for other analyses.Lung tissues were harvested for histological studies.Their arterial blood samples were collected for blood gas analysis.All data were expressed as mean ± standard deviation and analyzed with SPSS 20.0 （SPSS Inc.,Chicago,IL,USA）.The differences were considered to be statistically significant at P 〈 0.05.Results After removing death drain during the experiment,8 rats were put equally into five phase points of the last three groups,the results were analyzed statistically.PaO2：At each timepoint of 6,24,48,72 h,the control group PaO2 were obviously lower than the sham group （（69.55 ±5.11）,（62.05 ±6.54）,（53.24 ±7.65）,（50.00 ±7.45） vs （93.75 ±3.41）,（94.25 ± 2.19）,（93.63 ±2.33）,（93.25 ±1.83） mmHg （1 mmHg =0.133 kPa）,all P〈0.01）; at 6 h treatment group was close to sham group （（92.63 ±3.74） vs （93.75 ±3.41） mmHg,P =0.594） ; at 6 h control group PaO2 decreased to 70 mmHg and then gradually declined.And at each timepoint the treatment group PaO2 was significantly higher than the control group （（92.63 ± 3.74）,（87.50 ± 3.34）,（78.75 ± 3.11）,（71.38 ±3.74） vs （69.55 ±5.11）,（62.05 ±6.54）,（53.24 ±7.65）,（50.00 ±7.45） mmHg,all P 〈 0.01） ; PaCO2：treatment group PaCO2 was

关 键 词：肺表面活性物质相关蛋白质类 烧冲复合伤 急性肺损伤 

分 类 号：R563.8[医药卫生—呼吸系统]