两种PFC给药方式治疗ALI时血流动力学及病理积分的变化

The changes of hemodynamics and pathological score under two delivery methods of PFC on acute lung injury

目的:探讨两种氟碳(perfluorocarbon,PFC)给药方式治疗急性肺损伤时血流动力学及组织病理积分的变化。方法:采用肺灌洗诱导急性肺损伤(acute lung injury,ALI)后,动物分3组:①雾化吸入PFC(inhalation withaerosolized perfluorocarbon group,IAP)组;②部分液体通气(partial liquid ventilation group,PLV)组;③传统的机械通气(conventional mechanical ventilation group,CV)组。分别在ALI前、ALI及ALI后1、2、3、4 h 7个时段观察心率(HR)、平均动脉压(MAP)、呼吸末二氧化碳分压(PetCO2)、pH、动脉氧分压(PaO2)、肺泡动脉氧压差(AaDO2)等血流动力学指标的变化,实验结束后取肺组织做病理积分统计。结果:肺灌洗后3组动物PO2显著降低、AaDO2显著升高,两组PFC治疗干预后PaO2升高、AaDO2显著降低,与CV组比较具有统计学差异(P<0.05),且IAP组2 h后各时段与PLV组相应时段比较差异具有统计学意义(P<0.05)。病理学积分显示IAP组与PLV、CV两组比较均具有统计学差异(P<0.05)。结论:两种PFC给药方式下都具有改善肺氧合的作用,但随着时间的推移,雾化吸入组的效果更好,病理改变也最少。

Aim:To Explore the changes of hemodynamics and pathological score under two delivery methods of PFC in acute lung injury. Methods: After induction of acute lung injury by saline lavage,the animals were assigned randomly to 3 groups: ①The group of IAP(inhalation with aerosolized perfluorocarbon);②The group of PLV(Partical liquid ventilation);③The group of CV(conventional mechanical ventilation).Record the changes of hemodynamics(HR、MAP、PetCO2、pH、PaO2、AaDO2) at seven points of time during PLV and histological sections taken from different parts of lung to get the pathological score.Results: The PaO2 significantly improved,AaDO2 significantly decreased in two groups(IAP,PLV) after treatment compared with CV group(P<0.05).The PaO2 significantly improved,AaDO2 significantly decreased between IAP group and PLV group after two hours with PFC treatment(P<0.05).The pathological score significantly decreased in IAP group compared with PLV group and CV group.(P<0.05).Conclusion:Two delivery methods of PFC all had a role of impoving oxygenation,but with the passage of time,the best effect is in inhalation group,with least pathological score.