甘露醇对肢体缺血－再灌注致急性肺损伤防治作用的研究

Use of mannitol in prevention and treatment of acutepulmonary injury due to ischemia reperfusion of limbs:An experlmeental study in the area of plateu

用３８只大耳白兔随机分成５组。Ⅰ组：正常对照组；Ⅱ组：单纯缺血组；Ⅲ组：缺血再灌注６０ｍｉｎ组；Ⅳ组：甘露醇合剂治疗组；Ⅴ组：盐水治疗对照组。结果：Ⅳ组肺组织丙二醛含量无明显增高，与Ⅱ组、Ⅲ组及Ⅴ组相比相差非常显著（Ｐ＜０．０１）。血气分析、ＷＢＣ计数、ＷＢＣ粘附率、肺组织Ｄ／Ｗ重比等指标，Ⅳ组与Ⅲ组及Ⅴ组相比均有显著差异（Ｐ＜０．０５～０．０１）。Ⅳ组肺组织学仅见微血管轻度充血、少量ＰＭＮ聚集。实验结果揭示：甘露醇、抗坏血酸对下肢缺血－再灌注后所致急性肺损伤有较好的防治作用。

This study indicatcd iscbemia reperfusion oflower limbs might induce acute pulmonary injuty,Wealmed at Investigating the protective function ofmannitol and ascorbic acid (oxygen free raical scav-enger) by using pulmonary function and histologicaland ultrastructural indexes in experimental anim alsin the hypoxic area of plateau (3,700 meters abovesea level).The animals were radomly d ivided intofive groups:group I:normal controls; group Ⅱ:pure ischemia;group Ⅲ:ischemia reperfusion for 60minutes;group Ⅳ:treated with mixture of mannitol;group Ⅴ:controls with the administration ofsalinc,In group Ⅳ,the animals had ischemia in theirlower limbs for four hours and intravenous injectionof mixture of mannitol was given at the dosage of5ml/kg,30 and five minutes before the restorationof blood now.and five and 30 minutes after the res-toration of blood flow,In group Ⅴ,normal salinewas injected at the same dosage and at the same timeas mentioned in group Ⅳ。The results were asfollows:the content of MDA did not appear to havea marked increase,which indicated the existence of a significant difference as compared with groups Ⅱ,Ⅲand V(P<(0.01); blood gas analysis, WBC count,vvBC adhesive rate and pulmonary tissue D/W ingroup Ⅳ were shQ wn to be significantly different ascompared with group Ⅲ and group V(P<0.05～0.01);bistologically and ultrastructurally,onlymildmicrovascular congestion and aggregation of a smallamount of polymorphonuclears could be seen in thelungs in gtoup Ⅳ. It is suggested that mannitol andascorbic acid appear to have a favorable preventiveant therapeutic effects on acute pulmonary injury af-ter ischemia reperfusion of the lower limbs.Hence,early use of mannitol and ascorbic acid in patientswith ischemie limbs is recommended.