超声引导下注射肺表面活性物质预防早产兔肺损伤的实验研究  

Ultrasound guided injection of pulmonary surfactant for prevention of lung injury in premature rabbits:a experimental study

作　　者：赖为柽 何韶铮[1] 郑新颖 苏淇琛[1] 吕国荣 LAI Weicheng;HE Shaozheng;ZHENG Xinying;SU Qichen;LV Guorong(Department of Ultrasound,the Second Affiliated Hospital of Fujian Medical University,Fujian 362000,China)

机构地区：[1]福建医科大学附属第二医院超声科,福建省泉州市362000 [2]教育部泉州医学高等专科学校

出　　处：《临床超声医学杂志》2020年第12期881-884,共4页Journal of Clinical Ultrasound in Medicine

基　　金：泉州市科技计划项目(2018C071R);福建省自然科学基金项目(2018J01287);福建省临床重点专科建设项目资助[(2017)739]。

摘　　要：目的比较超声引导下羊膜腔内与胎肺注射肺表面活性物质(PS)预防早产兔肺损伤的效果。方法将15只新西兰孕兔随机分为胎肺注射PS组(胎肺组)、羊膜腔内注射PS组(羊膜腔组)及对照组,每组各5只。于妊娠第27天注药1 h后行剖宫产术,观察各组早产兔存活时间,检测支气管肺泡灌洗液中二棕榈胆碱酯磷酸(DPPC)和白细胞介素-6(IL-6)含量,取肺组织行肺损伤病理评分,检测PS相关蛋白-A(SP-A)表达水平和细胞凋亡指数,并用电镜观察Ⅱ型肺泡上皮细胞形态学改变。结果与对照组比较,胎肺组和羊膜腔组早产兔存活时间均明显延长,DPPC含量和SP-A表达水平均增加,肺组织细胞凋亡指数、肺损伤病理评分及IL-6含量均降低,差异均有统计学意义(均P<0.05);Ⅱ型肺泡上皮细胞板层小体增多,内质网肿胀减少。与羊膜腔组比较,胎肺组早产兔DPPC含量、SP-A表达水平及IL-6含量均增加,差异均有统计学意义(均P<0.05),余指标比较差异均无统计学意义。结论超声引导下羊膜腔内与胎肺注射PS均可有效预防早产兔肺损伤,但胎肺注射等量PS较羊膜腔注射效果更佳。Objective To compare the effect of ultrasound guided intra-amniotic cavity and fetal lung injection of pulmonary surfactant(PS)to prevent lung injury in premature rabbits.Methods Fifteen pregnant New Zealand rabbits were randomly divided into fetal lung injection PS group(lung group),amniotic cavity injection PS group(amniotic cavity group)and control group,each group has 5 rabbits.On the 27th day of pregnancy,rabbit fetuses were removed through cesarean section 1 h after injection.The survival time of premature rabbits in each group was observed,the content of dipalmitoyl phosphatidylcholine(DPPC)and interleukin-6(IL-6)in bronchoalveolar lavage fluid were detected.Lung tissue was taken for lung injury pathological score,the expression level of PS-active substance associated protein-A(SP-A)and apoptosis index were detected.Morphological changes of typeⅡalveolar epithelial cells were observed by electron microscopy.Results Compared with the control group,the survival time of premature rabbits in lung group and amniotic cavity group was significantly prolonged,the content of DPPC and SP-A expression level were increased,the apoptosis index of lung tissue and the pathological score of lung injury and IL-6 content were decreased.All were statistically significant(all P<0.05).The lamellar bodies of typeⅡalveolar epithelial cells was increased,and the swelling of endoplasmic reticulum was decreased.Compared with the amniotic cavity group,the content of DPPC,SP-A expression level and IL-6 content in preterm rabbits of lung group were increased,and the differences were statistically significant(all P<0.05),and there were no significant difference between the remaining indicators.Conclusion Both intra-amniotic and fetal lung injection PS can prevent lung injury in premature rabbits effectively.Compared with PS injected into amniotic cavity,PS injection into fetal lung with the same amount can obtain greater benefits,which is expected to be a new treatment to prevent lung injury in premature infants.

关 键 词：超声引导 肺损伤 肺表面活性物质 兔 早产 

分 类 号：R445.1[医药卫生—影像医学与核医学]