单侧肺误吸胃蛋白酶呼吸力学及双侧肺病理学的改变

Changes of respiratory mechanics and pathology of both lungs after 1 lung aspiration of pepsin in rabbits

目的:观察误吸胃蛋白酶后呼吸力学及双侧肺组织学的改变。方法:日本纯种大耳白兔8只,单侧肺注入胃蛋白酶1.5 m l/kg。分别在基础状态、误吸后1 h、2 h,从呼吸力学测定仪上直接读出气道峰压(PIP)、平台压(Pp lat)、肺胸顺应性(CLT,并采动脉血1 m l后立即测定血气。误吸2 h光镜下观察双侧肺组织病理变化。结果:气道峰压(PIP)、气道平台压(Pp lat)在胃蛋白酶注入后各时间点均显著增高(P<0.05),胸肺顺应性(CLT)显著下降(P<0.05),且2 h时点的变化明显大于1 h。误吸侧肺肺泡间隔增宽,壁增厚,腔内充满红细胞和大量的嗜酸粒细胞。右侧肺细支气管腔内偶见红血球和中性粒细胞,同时有肺泡破坏。左肺中也可见肺泡间隔增宽和明显的嗜酸粒细胞浸润。结论:单侧肺误吸胃蛋白酶在明显引起误吸侧呼吸力学的改变的同时,双侧肺均产生明显的病理改变,提示单侧肺误吸胃蛋白酶引起继发性肺损伤。

Objective： To study the changes of respiratory mechanics and pathology of both lungs after 1 lung aspiration of pepsin in rabbits. Methods： Pepsin of 1.5 ml/kg was perfused into the right lungs of 8 rabbits （3.0 - 4.0 kg）.The parameters of respiratory mechanics of the right lungs were measured and 1 ml arterial blood was drawn for blood gas.analysis 1 hour and 2 hours after aspiration. The pathological changes of both lungs were observed 2 hours after aspiration. Results. After aspiration of pepsin, the peak inspiratory pressure and plateau pressure significantly increased （ P 〈 0. 05 ）, and the lung - thorax compliance significantly decreased （ P 〈 0.05）. The pathological observation showed that the left lungs were affected in different degrees. Conclusion： One lung aspiration of pepsin causes the changes of respiratory mechanics of the lung and pathological changes of both lungs, which indicates that one lung aspiration of pepsin may induce secondary lung injury.