纯氧对脓毒症大鼠所致急性肺损伤的保护作用  

100% oxygen inhalation protected against septic lung injury in rats

作　　者：张二飞[1] 袁清霞[1] 罗志锴[1] 侯立朝[2] 胡彬[1] 

机构地区：[1]延安大学附属医院麻醉科,716000 [2]第四军医大学西京医院麻醉科

出　　处：《临床麻醉学杂志》2015年第9期912-917,共6页Journal of Clinical Anesthesiology

基　　金：国家自然科学基金(81171839)

摘　　要：目的探索纯氧通气对脓毒症大鼠所致急性肺损伤的保护作用。方法 SD大鼠采用盲肠结扎穿孔(cecal ligation and puncture,CLP)制备脓毒症模型,按照随机设计方法大鼠均分为四组:假手术+空气组(A组),假手术+纯氧组(P组),模型+空气组(C组),模型+纯氧组(O组)。P组与O组动物在手术后6h持续吸入纯氧2h,A组与C组动物则给予自由呼吸空气。评估术后24h肺的组织学形态及组织学评分,肺干湿比、支气管灌洗液(bronchial alveolar lavage fluid,BALF)中总蛋白和白蛋白含量、肺组织匀浆髓过氧化物酶(myeloperoxidase,MPO)活性等肺损伤指标,以及动脉血气分析。记录大鼠手术后7d生存率。结果 A组和D组术后7d内生存率均为100%。与A组和P组比较,C组术后7d生存率明显降低(P<0.01),且肺部组织学形态改变明显(P<0.01);肺损伤指标明显升高(P<0.01);pH、PaO2、PaO2/FiO2水平明显下降(P<0.01),PaCO2、血乳酸水平明显升高(P<0.01);O组术后7d生存率明显降低(P<0.05),肺组织病理也有损伤,且病理学评分轻微升高(P<0.05),但肺损伤指标差异无统计学意义,动脉血气分析仅血乳酸水平明显升高(P<0.05)。与C组比较,O组术后7d生存率明显升高(P<0.05);肺组织病理改变改善,病理学评分、肺损伤指标、PaCO2明显降低(P<0.01);pH、PaO2、PaO2/FiO2水平明显升高(P<0.01)。结论本实验证实了纯氧对脓毒症大鼠所致急性肺损伤具有改善作用。Objective To explore the protective effect of ventilation by 100% oxygen on septic lung injury in rats. Methods Sepsis model made by cecal ligation and puncture （CLP） was performed on SD rats. SD rats were randomly divided into 4 groups： sham＋air（group A）, CLP＋air （group C）, sham＋100% oxygen （group P） and CLP＋100% oxygen （group O） groups. 100% oxygen was given to animals by exposing 100% oxygen for 2 hours and other animals exposed to air 6 hours after the operation. The lung morphology and histology scores, wet to dry ratio, total protein and albumin contents in BALF, MPO activity of lung tissue, and arterial blood gases were detected 24 hours after operation. The 7 d survival rate was also recorded. Results The survival rate of 7d after operation in group A and P were 100%. Compared with group A, no pathological changes in the lung tissue and the pathological scores were no statistical difference, the assessment indexes of lung iniury and pulmo- nary function were also no statistical significant difference in group P; the survival rate of 7d after op- eration decreased significantly（PG0. 01）, the morphological changes of lung tissue were changed ob- viously（P〈0. 01）, the pathological score was significantly higher （P〈0. 01）, indicators of lung inju- ry were significantly higher （P〈0. 01）, pH, PaO2, PaO2/FiO2 levels were decreased significantly （P 〈0. 01）, PaCO2, lactate levels were increased significantly in group C（P〈0. 01） ; the survival rate of 7d after operation decreased significantly （P〈 0. 05）, lung tissue also has pathological injury and pathological score slightly higher （P〈0.05）, the lung injury index difference was not statistically sig- nificant, arterial blood gas analysis only blood lactate levels was significantly increased in group O（P 〈0. 05）. Compared with the group C, the survival rate of 7d after operation was significantly higher （P〈0. 05）, pathological changes of lung tissue were improved, pathological

关 键 词：脓毒症 盲肠结扎穿孔 纯氧 肺损伤 

分 类 号：R459.7[医药卫生—急诊医学]