乌司他丁对爆震引起兔急性肺损伤血气及肺病理的影响  

The effect of ulinastatin on blood gas analysis in rabbits with acute lung injury following a blast

作　　者：袁耒[1] 代尊强 史岩[1] 徐傲[1] 邹志强[1] 卢兆桐[1] 

机构地区：[1]济南军区总医院胸外科,济南250000

出　　处：《中华急诊医学杂志》2016年第3期301-304,共4页Chinese Journal of Emergency Medicine

基　　金：全军医药卫生科研基金项目（08G01800）

摘　　要：目的探讨及分析乌司他丁（UTI）对肺爆震伤引起新西兰大白兔急性肺损伤血气分析及肺脏病理的影响。方法将24只健康新西兰大白兔在致伤距离11cm处用炸药制造ALI模型，出现ALI后随机（随机数字法）分成A、B两组，B组动物在致伤后0．5、6、12、24h肌注UTI，A组动物肌注等体积生理盐水，利用便携式血气分析仪测定伤前及伤后每次给药前的动脉血pH值、二氧化碳分压（PaCO2）及血氧分压（PaO2），48h后处死所有家兔，观察双肺大体变化及HE染色肺组织损伤的程度。结果B组兔肺脏中肺水肿及炎性细胞的浸润程度较A组明显减轻。血气分析变化：①pH：伤后24hA组为（7．24±0．07），B组为（7．35±0．06），两组比较差异具有统计学意义（P〈0．05），B组高于A组。②PaO2：伤后24hA组（50．5±9．9）mmHg（1mmHg=0．133kPa），B组（78．1±8．4）mmHg，两组比较差异具有统计学意义（P〈0．05），B组高于A组。③PaCO2：伤后24hA组（52．4±5．5）mmHg，B组（42．8±4．5）mmHg，两组比较均差异具有统计学意义（P〈0．05），B组低于A组。结论乌司他丁可以明显减轻爆震伤引起的Au兔的酸中毒，降低PaCO2及提高PaO2，提高氧合指数，减轻肺水肿及中性粒细胞浸润。Objective To study the effect of ulinastatin （UTI） on blood gas analysis in rabbits with acute lung injury （ALI） after an explosion. Methods A total of 24 healthy New Zealand white rabbits were made to be ALI models by an explosion at a distance of 11 cm. The rabbits met the criteria of ALI, and were randomly （ random number） divided into A and B groups. In group B, rabbits received UTI injected at 0. 5 h, 6 h, 12 h, 24 h after modeling. In group A, an equal volume of saline was given to rabbits instead at the same intervals after modeling. Arterial blood pH, carbon dioxide partial pressure （PaCO2 ） and partial pressure of blood oxygen （PaO2 ） were determined by a portable blood gas analyzer before modeling and at given intervals after modeling. All rabbits were sacrificed after 48 h later. The pathological changes of lung tissue were observed with naked eye and extent of lung injury with HE staining. Results Compared with group A, pulmonary edema and infiltration of inflammatory cells in the lungs of rabbits in group B were less significant. The blood gas analysis showed there were significant difference in pH at 24 h after injury between group A （7.24 ± 0.07） and group B （7. 35± 0. 06）, P〈0. 05. There was significant difference in PaO2 at 24 h after injury between group A （ 50. 5 ± 9.9 ） mmHg and group B （ 78. 1 ±8.4 ） mmHg, P 〈 0. 05. And there was significant difference in PaCO2 at 24 h after injury between group A （52.4±5.5 ） mmHg and group B （42. 8 ± 4. 5 ） mmHg, P 〈 0. 05. Conclusion UTI can significantly reduce acidosis, PaCO2 and increase PaO2 in rabbits with ALI following a blast, improving oxygenation and mitigating lung histopathological changes.

关 键 词：爆震伤 急性肺损伤 乌司他丁 血气分析 病理 

分 类 号：R563[医药卫生—呼吸系统] R641[医药卫生—内科学]