摘要
目的 观察甲泼尼龙治疗急性百草枯（PQ）中毒家猪肺损伤的最佳剂量.方法 取20 ml含20％PQ原液对家猪进行腹腔注射,制备急性PQ中毒家猪急性肺损伤（ALI）/急性呼吸窘迫综合征（ARDS）模型,将造模成功的家猪模型随机分为PQ染毒对照组,5、15、30 mg/kg甲泼尼龙组.4组家猪模型均在常规补液基础上给予干预,采用脉搏指示连续心排血量（PICCO）监测造模前、造模成功时（t0）、不同处理之后12 h（t12）、24 h（t24）及36 h（t36）时心率、平均动脉压、血管外肺水指数（EVLWI）、肺血管通透性指数（PVPI）,计算各时点的氧合指数（PaO2/FiO2）.在造模前、t0时及不同处理后12、24、36 h分别对家猪进行肺组织穿刺,采用苏木精-伊红（HE）染色法观察肺组织病理变化,并对肺组织进行肺损伤评分.结果 （1）组间比较：造模前及t0时,4组家猪EVLWI和肺组织病理评分的差异无统计学意义（P＞0.05）;在不同处理后12、24、36hEVLWI和肺组织病理评分的差异均有统计学意义（P＜0.05）.组内比较：t0时,4组家猪EVLWI和肺组织病理评分均较造模前明显上升,差异有统计学意义（P＜0.05）;在不同处理后,PQ染毒对照组家猪的EVLWI和肺组织病理评分持续升高,5、15、30 mg/kg甲泼尼龙组家猪EVLWI和肺组织病理评分均呈先下降后升高趋势,与组内t0比较,差异均有统计学意义（P＜0.05）.（2）组间比较：造模前及t0时,4组家猪氧合指数差异无统计学意义（P＞0.05）,在不同处理后12、24、36 h,氧合指数的差异均有统计学意义（P＜0.05）.组内比较：t0时,4组家猪氧合指数均较造模前明显下降,差异有统计学意义（P＜0.05）;在不同处理后,PQ染毒对照组家猪的氧合指数持续降低,5、15、30 mg/kg甲泼尼龙组家猪的氧合指数呈先升高后下降趋势,与组内t0比较,差异均有统计学意义（P＜0.05）.（3）各组药物治疗36 h后的EVLWI值�
Objective To observe the best dose of methylprednisolone improving lung injury in swine with paraquat intoxication.Methods Acute lung injury （ALI/ARDS） model was made by an intraperitoneal injection of a large dose of 20% PQ solution20 millilitres in swine.Then 24 swine were randomly divided into 4 groups：exposed PQ control group,5 mg/kg of methylprednisoloue group,15 mg/kg of methylprednisolone group,30 mg/kg of methylprednisolone group.All groups were based on the conventional rehydration for intervention,Arterial blood samples were collected before modeling and 0,12,24,36 hours after different processing for blood gas analysis.At the same time heart rate （HR）,mean arterial pressure （MAP）,extravascular lung water index （EVLWI） and pulmonary vascular permeability index （PVPI） were measured by using PICCO （pulse indicator continuous cardiac output）,lung tissue was obtained by punctureneedle to produce lung biopsy,then observe the pathological changes of lung tissue in the microscope.Results 1.Comparison between groups：there is no significant difference about extravascular lung water index （EVLWI）and semi-quantitative score of lung tissue pathology in four groups （P〉0.05） before modeling,so is t0,there is significant difference at about extravascular lung water index and semi-quantitative score of lung tissue pathology 12 h,24 h and 36 h after different processing （P〈0.05）.Within the group：EVLWI and semi-quantitative score of Lung tissue pathology in four groups significantly increased when the model was made （P〈0.05）,after different processing,EVLWI and semi-quantitative score of Lung tissue pathology in exposed PQ control group kept going up,in other three groups,EVLWI and semi-quantitative score of lung tissue pathology went down first and then went up,there is significant difference compared with t0 （P〈0.05）.2.Comparison between groups：there is no significant difference about oxygenation index in four groups （P〉0.05） before modeling,so is t0,the
出处
《中华劳动卫生职业病杂志》
CAS
CSCD
2015年第1期24-28,共5页
Chinese Journal of Industrial Hygiene and Occupational Diseases
基金
河南省重点科技攻关计划项目（102102310094）
河南省医学科技攻关计划项目（201003049）
国家临床重点专科（2012649）
关键词
百草枯
急性肺损伤
甲泼尼龙
Paraquat
Acute lung injury
Methylprednisolone
