呼吸窘迫综合征肺表面活性物质变化的探讨

Study of changes of pulmonary surfactant in respiratory distress syndrome and their mechanisms in rabbits

实验性呼吸窘迫综合征（ＲＤＳ）兔支气管肺泡灌洗液（ＢＡＬＦ）总磷脂，磷脂酰胆碱和磷脂酰甘油减少，白蛋白和Ｃ－反应蛋白升高，且与ＢＡＬＦ表面张力增大相关。钌红染色见肺泡表面活性层失去连续、绒状结构，而以变性状态散落于肺泡腔。还见到纤维素阻拦肺表面活性物质（ＰＳ），使之不能向肺泡表面解聚的特殊现象。以上结果表明，ＰＳ质、量和形态结构的异常在实验性ＲＤＳ发病中有重要作用；蛋白性肺泡渗出物能破坏或抑制ＰＳ的结构和功能。

In the rabbit model of experimental respiratory distress syndrome(RDS) it was found that total phospholipids, phosphotidylcholine,and phosphotidylglycerol were decreased in the bronchoalveolar lavage fluid (BALF)and the amount of albumin and C-reactive protein was increased in BALF in the RDS rabbits,which was correlated with an elevation of the surface tension of BALF.With ruthenium red staining,the continuous and velvety structure of the alveolar surface active layer of RDS animals was seen being converted into aggregated or vacuolized forms scattered in the alveolar cavity.It was also found that pulmonary surfactant was prevented by fibrin from unfolding on the alveolar surface.These findings suggest that the abnormality of the quality,quantity and morphology of pulmonary surfactant plays a critical role in the pathogenesis of RDS and the proteinous exudate of the alveoli can destroy the structure and inhibit the function of pulmonary surfactant.