摘要
目的探讨盐酸戊乙奎醚(PHC)联合地塞米松(DXM)对兔胸部爆震伤ARDS的治疗作用。方法采用健康新西兰大白兔制作兔胸部爆震伤ARDS模型,将符合ARDS诊断标准的兔随机分为5组:B组,爆炸致ARDS组(n=10);C组,低剂量(0.8mg/kg)PHC组(n=9);D组,高剂量(1.5mg/kg)PHC组(n=9);E组,DXM(3mg/kg)组(n=8);F组,高剂量(1.5mg/kg)PHC+DMX(3mg/kg)组(n=7)。另取6只健康新西兰大白兔作为正常对照组(A组)。C-F组动物均于造模成功后0.5、12、24、36、48h肌注给予相应药物,A、B组动物给予等体积生理盐水。监测伤前及治疗(第一次给药)后6、24、48、72h实验动物的呼吸、心率、氧合指数及外周静脉血肿瘤坏死因子α(TNF-α)、白细胞介素(IL-6)含量;第一次给药后72h处死动物,收集支气管肺泡灌洗液(BALF),检测其中TNF-α、IL-6含量,取肺组织测定肺湿/干重比,并行HE染色观察肺组织病理变化。结果 B组呼吸、心率、肺湿/干重比及外周血和BALF中的TNF-α、IL-6含量均较A组明显升高(P<0.05),氧合指数则较A组明显降低(P<0.01)。经DXM和(或)PHC干预后,各指标均有不同程度好转,其中F组明显优于C、D、E组(P<0.05)。结论高剂量PHC联合DXM对兔爆震伤所致ARDS具有一定治疗作用,且疗效明显优于单用PHC或DXM。
Objective To discuss the therapeutic effects of penehyclidine hydrochloride combined with dexamethasone on Acute Respiratory Distress Syndrome（ARDS） after a thoracic blast injury in rabbits.Methods Healthy New Zealand white rabbits were used to establish the ARDS model induced by a thoracic blast injury.The rabbits conforming to the diagnostic standard of ARDS were divided into 5 groups randomly： B group,ARDS caused by blast（n=10）;C group,PHC（n=9） with low dose（0.8mg/kg）;D group,PHC（n=9） with higher dose（1.5mg/kg）;E group,DXM（n=8）（3mg/kg）;F group,PHC＋DMX（n=7） with higher dose（3mg/kg）.Another set of six healthy New Zealand white rabbits were used as the control group（A group）.Rabbits in the C-F group were injected with a drug at 0.5,12,24,36,and 48 h after being modeled successfully.At the same time,the rabbits in groups A and B were injected with saline in equal volumes as that in the therapeutic groups.The breathing,heart rate,and oxygenation indices,as well as the levels of TNF-α and IL-6 in the peripheral blood were monitored before the rabbits were injured,and at 6,24,48,and 72 h after medical treatments（initially given drugs）.The rabbits were sacrificed at 72 h after they were initially given drugs.Bronchoalveolar lavage fluid（BALF） was collected in which the levels of TNF-α and IL-6 were detected by ELISA.Lung tissue specimens were taken to measure the lung water content-dry weight（W/D） ratio,and hematoxylin and eosin staining was used for observing the pathological changes of the lung tissues.Results Heartbeats,breathings,W/D ratios,and contents of TNF-α,IL-6 in peripheral blood or in BALF in group B were higher than that in group A（P〈0.05）.The oxygenation index in group B was apparently lower than that in group A（P〈0.01）.All indexes increased in varying degrees after the treatments with DXM and/or PHC.Group F showed better results than groups C,D,and E（P〈0.05）.Conclusions PHC combined with DXM has a certain therapeutic effect
出处
《解放军医学杂志》
CAS
CSCD
北大核心
2011年第11期1154-1158,共5页
Medical Journal of Chinese People's Liberation Army
基金
全军医药卫生科研基金(08G103)
关键词
爆震伤
呼吸窘迫综合征
成人
盐酸戊乙奎醚
地塞米松
细胞因子类
模型
动物
blast injuries； respiratory distress syndrome,adult； penehyclidine hydrochloride； dexamethasone； cytokines； models,animal
