雾化吸入前列腺素E_1对盐酸所致急性肺损伤的影响  

Effects of aerosolized prostaglandin E1 inhalation on acute lung injury induced by hydrochloric acid aspiration

作　　者：岳子勇[1] 李文志[1] 孙国强[1] 纪存良[1] 孙波[1] 李恩友[1] 

机构地区：[1]哈尔滨医科大学附属第二医院麻醉科,150086

出　　处：《中华麻醉学杂志》2003年第1期50-54,共5页Chinese Journal of Anesthesiology

摘　　要：目的 探讨雾化吸入前列腺素E1(PGE1)对盐酸所致急性肺损伤(ALI)循环及呼吸功能的影响。方法 18头健康家猪,麻醉及相关操作后记录平均动脉压(MAP)、平均肺动脉压(MPAP)、动脉血氧分压(PaO2)、动脉血二氧化碳分压(PaCO2)及肺顺应性作基础值,经气管导管向肺内注入0.1mol/L的盐酸溶液,直至PaO2<13.3 kPa并持续30 min,记录上述指标。随机分为A、B、c三组,每组6头。A组只接受机械通气无呼气末正压(PEEP),B组与A组同,但附加PEEP,C组在B组的基础上雾化吸入PGE1,观察4 h,每1 h记录上述指标一次。实验结束后开胸取肺并做组织学检查。结果 三组MAP在ALI后均明显下降,并维持在12 kPa左右,组间未见差异(P>0.05)。三组MPAP在ALI后明显升高,A、B两组MPAP一直保持在(4.24±0.52)kPa以上,组间无差异(P>0.05),而C组则明显下降至(3.42±0.31)kPa以下,与A、B组比较呈差异有显著性(P<0.05)。B、C两组的PaO2在分组后均较A组的明显升高(P<0.05),以C组最明显。B、C组肺顺应性明显高于A组(P<0.05)。肺组织切片显示C组的肺组织损伤明显较A、B组轻,B组也轻于A组。结论 雾化吸入PGE,能改善盐酸所致ALI的呼吸功能,并在维持MAP平稳的情况下降低肺动脉压。Objective To investigate the effects of aerosolized prostaglandin E1 (PGE1) inhalation on circulatory and respiratory function during lung injury ( ALI ) induced by hydrochloric acid (HC1) aspiration.Methods Eighteen healthy pigs of either sex, weighing (15.5±2.0) kg were anesthetized with intraperitoneal pentobarbital sodium (50 mg/kg) and intubated and mechanically ventilated (FiO2 = 1.0, VT = 10-15 ml/kg, RR = 16 bpm, I: E = 1:2), anesthesia was maintained with infusion of ketamine, procaine and succinylcholine. Femoral artery was cannulated for BP monitoring and blood sampling. Swan-Ganz catheter was placed in the pulmonary artery via right external jugular vein. Dilute HC1 (0.1 mol/L) was instilled via trachea into lungs until PaO2 was < 13.3kPa. Arterial blood gases, MAP, MPAP and dynamic lung compliance were measured before induction of ALI (T0 ) , when ALI was induced (T1) and 1,2,3 and 4 h there after (T2-5). The animals were randomly divided into three groups according to the treatment they received : group A received IPPV alone ( n = 6) ; group B IPPV + PEEP(0.69 kPa) ( n = 6) and group C received IPPV + PEEP + aerosolized PGE, inhalation (6μg·kg-1· h-1 ) . Four hours after induction of ALI, the lungs were removed for light microscopic and electron microscopic examination. Results MAP decreased significantly after induction of ALI in all three groups but there was no significant difference in MAP among the three groups. MPAP increased significantly after induction of ALI in all three groups and remained high during the 4 hour treatment in group A and B but decreased significantly from T2 on in group C. PaO2 increased significantly during treatment in group B and C and was significantly higher in group C than in group B. PaCO2 was highest in group A and lowest in group C among the 3 groups. Dynamic lung compliance decreased in all animals after induction of lung injury but was gradually increasing significantly during treatment. Microscopic examination showed that the lung injury was severest in gro

关 键 词：雾化吸入 前列腺素E1 急性肺损伤 成人型呼吸窘迫综合征 ALI 呼吸功能 

分 类 号：R614[医药卫生—麻醉学]