海水淹溺肺水肿大鼠肺表面活性物质磷脂的变化

Phospholipid changes of pulmonary surfactant in rats with pulmonary edema after seawater drowning

目的:研究海水淹溺肺水肿大鼠的肺表面活性物质磷脂成分的动态变化。方法:32只雄性SD大鼠随机均分为4组,分别为对照组、淹溺4h组、淹溺8h组、淹溺16h组,建立海水淹溺性肺水肿模型,分别于4、8、16h处死大鼠,再行支气管肺泡灌洗(40ml/kg),以Bartlett法测定支气管肺泡灌洗液(BALF)及肺组织匀浆中总磷脂(TPL),以Mason法测定其中饱和磷脂酰胆碱(DSPC),以考马斯亮蓝法测定BALF中的总蛋白(TP),亦测定肺组织中的TPL和DSPC的含量。结果:对照组、淹溺4h组、淹溺8h组、淹溺16h组BALF中TPL测定值分别为(9.1±1.1)、(6.7±2.2)、(11.7±1.3)、(9.0±3.0)mg/kg;DSPC测得值分别为(2.8±0.6)、(1.6±0.7)、(3.1±0.5)、(3.1±0.8)mg/kg。与对照组相比,淹溺4h组的TPL、DSPC均减少,DSPC/TPL比例也减小(P<0.05)。8h后TPL和DSPC含量恢复至正常水平。各组经过支气管肺泡灌洗后的肺实质内的TPL测定值分别为(100.8±11.3)、(101.1±14.5)、(102.7±14.5)、(120.4±21.2)mg/kg,DSPC测定值分别为(19.2±3.6)、(19.0±6.0)、(24.6±6.0)、(23.6±9.0)mg/kg,各组间无显著差异。海水淹溺各时段BALF中的TP分别为(47.2±18.3)、(35.1±11.6)、(29.6±5.0)mg/kg,均明显高于对照组的(14.9±2.7)mg/kg(P<0.05),而以淹溺4hTP含量最高。结论:海水淹溺后肺泡表面活性物质有效成分减少,外源性表面活性物质替代治疗可能对海水淹溺肺水肿有效。

Objective： To observe the phospholipid changes of pulmonary surfactant in rats with pulmonary edema after seawater drowning （PE-SWD）. Methods： Rat models of PE-SWD were obtained by injecting seawater （4 ml/kg） intratracheally. Thirty-two male Sprague-Dawley rats were equally randomized into 4 groups： control group, 4 h drowning group, 8 h drowning group, and 16 h drowning group. Bronchoalveolar lavage （BAL） was performed with normal saline at a total dose of 40 ml/kg 4 h,8 h and 16 h after drowning. Total phospholipid （TPL） was analyzed by Bartlett＇s method, dipalmitoylphosphatidylcholine（DSPC） by Mason＇s method, and total protein （TP） by Coomassie brilliant blue method in bronchial alveolarlavage fluid （BALF）. TPL and disaturated phosphatidylcholine（DSPC） were also determined in lung parenchyma and the ratios of DSPC/TPL and DSPC/TP were caculated. Results： The concentrations of TPL in BALF of control group, 4 h group, 8 h group, and 16 h group were （9. 1±1. 1）, （6.7±2.2）, （11.7±1.3） and （9.0±3.0） mg/kg, respectively, and those of DSPC were （2.8±0.6）,（1.6±0.7）, （3.1±0.5） and （3.1±0.8） mg/kg, respectively. TPL, DSPC, and DSPC/TPL in BALF decreased in 4 h group compared with those of control group （P〈0.05） and recovered in 8 h group. TPI.s in lung parenchyma in control,4 h,8 h and 16 h groups were （100.8±11.3） ,（101.1±14.5）, （102.7±14.5） and （120.4±21.2） mg/kg, respectively, and DSPCs in lung parenchyma were（19.2±3. 6）,（19.0±6.0）,（24. 6±6.0） and （23. 6±9.0） mg/kg, respectively.There was no significant difference between all groups. TPs in BALF were （ 14.9±2.7）, （47.2±18.3）, （35. 1±11.6） and（29.6±5.0） mg/kg, respectively. TPs of the drowning groups were higher than those of control group （P〈0.05）. Conclusion： The effective components of pulmonary surfactant are decreased after seawater drowning. Pulmonary edema after seawater drowning may be treated by exogenous pulmonary surfactant replacement therapy.