摘要
目的本实验观察了猪肺表面活性物质（PPS）混悬液对肺灌洗致免急性呼吸窘迫综合征（ARDS）的治疗作用。方法将31只兔分为生理盐水对照组和高、中、低三个不同剂量PPS给药组，用生理盐水在体肺灌洗诱发兔ARDS后，经气管分别滴入生理盐水或80mg／kg、120mg／kg、160mg／kg的PPS。于兔灌洗前、灌洗后和给药后不同时间抽取动脉血进行血气分析。实验过程中观察呼吸频率．动物的生存时间。共观测8h。实验结束后，处死动物取肺甲醛固定后行病理学检查。结果肺灌洗后兔的呼吸频率、血气指标和肺病理学的改变均符合ARDS表现，肺灌洗后生理盐水治疗组兔在1h内死亡率为11／12。而PPS气道给药三组除了低剂量组有2只兔的生存时间超过6h．但小于8h外，中高剂量组所有兔的存活时间均超过8h。三个PPS剂量组给药后15-30min兔的呼吸频率均明显减慢，动脉血PaO2显著提高．PaCO2和血pH分别在1h和6h降至正常。肺泡萎陷、肺出血和炎细胞浸润状况也明显改善。中、高剂量组在提高PaO2．延长动物生存率和改善肺病理变化方面比低剂量组效果更好。结论PPS对于兔肺灌洗型ARDS具有明显的治疗作用。
Objective To evaluate the therapeutic efficacy of intratracheal instillation of porcine pulmonary surtactant （PPS） in rabbits with lung lavage--induced acute respiratory distress （ARDS）. Methods Adult rabbits were anesthetized and underwent a tracheotomy and arterial catheter insertion. ARDS was induced in adult rabbits by repeated lung lavage in vivo to remove alveolar surfactant phospholipids. When rabbit＇s PaO2 had decreased to 40±5 mmHg the rabbits were randomly divided into a control group intratracheally instilled saline and three doses of PPS groups intratracheally instilled 80mg/kg, 120mg/kg and 160 mg/kg of PPS suspension respectively. Arterial blood gases, respiratory rate, survival rate, as well as histological analysis of lung of all rabbits were examined for 8 hrs. Results Treatment rabbits with three doses of PPS significantly increased PaO2, decreased respiratory rate and PaCO2, as well as led to marked improvements in the survival rate and the histological appearance of the lungs. The medium and high doses of PPS were more effective than that of low dose of PPS. Conclusion Porcine surfactant replacement has therapeutic effects on lung lavage--induced acute respiratory distress syndrome in adult rabbits.
出处
《中国急救医学》
CAS
CSCD
北大核心
2006年第4期282-284,共3页
Chinese Journal of Critical Care Medicine
基金
上海市科委重点基础项目资助(03JC14002)
