富氧全氟化碳乳剂对油酸诱导急性呼吸窘迫综合征家兔的保护作用  

Protection of oxygen-enriched perfluorocarbon emulsion for the rabbit model with acute respiratory distressed syndrome induced by oleic acid

作　　者：闻郑峰 吕友 林兆奋 WEN Zhengfeng;LYV You;LIN Zhaofen(Department of Critical Medicine,The Second Hospital of Yinzhou District,Ningbo 315192,China.)

机构地区：[1]鄞州区第二医院重症医学科,浙江宁波315192 [2]鄞州区第二医院肛肠外科,浙江宁波315192 [3]海军军医大学附属长征医院

出　　处：《全科医学临床与教育》2021年第6期497-500,F0003,共5页Clinical Education of General Practice

基　　金：国家科技支撑计划(2014BAK05B02)。

摘　　要：目的探讨富氧全氟化碳乳剂对油酸诱导急性呼吸窘迫综合征(ARDS)家兔的保护作用。方法将18只新西兰家兔随机分为油酸+乳剂组、油酸组和对照组,每组6只。采用油酸法建立家兔ARDS模型。造模成功后,油酸+乳剂组吸入富氧全氟化碳乳剂15 min,油酸组和对照组雾化吸入等量0.9%氯化钠注射液。观察三组在基线、成模、雾化吸入结束后0 min、5 min、15 min、30 min、60 min、120 min、240 min、360 min时的血氧分压(PaO_(2))以及雾化结束后360 min血清和肺灌洗液中肿瘤坏死因子-α(TNF-α)、白细胞介素-1β(IL-1β)的浓度,同时,计算Smith肺损伤评分、肺系数、肺通透指数,并在肉眼和显微镜下观察肺组织病理学改变。结果在雾化吸入富氧全氟化碳乳剂结束后0 min和360 min,油酸+乳剂组的PaO_(2)高于油酸组,差异均有统计学意义(t分别=2.56、2.30,P均<0.05)。在雾化结束后360 min,油酸+乳剂组的Smith肺损伤评分和肺系数低于油酸组,差异均有统计学意义(t分别=2.56、2.34,P均<0.05)。在雾化结束后360 min,油酸+乳剂组的血清和肺泡灌洗液中TNF-α、IL-1β浓度高于油酸组,但差异均无统计学意义(t分别=0.92、0.52、0.82、0.38,P均>0.05)。油酸组和油酸+乳剂组均有肺病理损害,可见不同程度的水肿、出血、坏死、炎症渗出以及肺泡萎缩或消失。结论富氧全氟化碳乳剂能够提高油酸诱导ARDS家兔的血氧分压和减轻肺组织的损伤程度,但不能抑制炎症因子的释放。Objective To explore the protection of oxygen-enriched perfluorocarbon emulsion for the rabbit model with acute respiratory distressed syndrome induced by oleic acid. Methods Eighteen New Zealand rabbits were randomly divided into oleic acid + emulsion group,oleic acid group,and basic control group with 6 rabbits in each.The rabbit model of ARDS was induced by oleic acid.After successfully modeling,the rabbits in oleic acid + emulsion group were vaporized oxygen-enriched perfluorocarbon emulsion for 15 min,and the rabbits in the basic control group and oleic acid group were given the same amount of vaporized normal saline inhalation.Before modeling for 30 min(basic value),after modeling for 30 min,and 0 min,5 min,15 min,30 min,60 min,120 min,240 min,360 min after inhalation,the PaO2 was observed in three groups,tumor necrosis factor-α(TNF-α)and interleukin-1β(IL-1β)at 360 min after inhalation and the Smith lung injury score,the lung coefficient and lung permeability index were calculated.The lung tissue was collected and the lung pathological changes were observed. Results Compared with oleic acid group,the PaO2 of oleic acid + emulsion group was higher at 0 min and 360 min after inhalation of oxygen-enriched perfluorocarbon emulsion(t=2.56,2.30,P<0.05).At 360 min after inhalation,the Smith lung injury score and lung coefficient of oleic acid + emulsion group were lower than those of the oleic acid group(t=2.56,2.34,P<0.05),while the differences in concentrations of TNF-α and IL-1β in serum and BALF between two groups were not statistically significant(t=0.92,0.52,0.82,0.38,P>0.05).In the oleic acid group and oleic acid + emulsion group,there were pathological damages such as edema,hemorrhage,necrosis,inflammatory exudation and alveolar atrophy or disappearance.Conclusion Oxygen-enriched perfluorocarbon emulsion can increase the partial pressure of blood oxygen and reduce the degree of lung injury in ARDS rabbits induced by oleic acid,but it can not inhibit the release of inflammatory factors.

关 键 词：急性呼吸窘迫综合征 油酸 全氟化碳 二棕榈酸卵磷脂 

分 类 号：R563.8[医药卫生—呼吸系统]