羟乙基淀粉130/0.4对兔内毒素性急性肺损伤的影响

Effects of hydroxyethyl starch 130/0.4 on lipopolysaccharide-induced acute lung injury in rabbits

目的观察羟乙基淀粉130/0.4(万汶,Voluven)对兔内毒素性急性肺损伤的影响。方法雄性新西兰大白兔24只,随机分为三组,每组8只。脂多糖(LPS)组与LPS+Voluven组用LPS“二次打击法”复制内毒素性肺损伤模型,LPS组用生理盐水(NS),LPS+Voluven组羟乙基淀粉10ml/kg后再用NS维持输液;NS组用NS代替LPS注射,用NS维持输液。于第2次注射LPS/NS前(T0)、第2次注射LPS/NS后1h(T1)、4h(T4)、8h(T8)测定氧合指数(PaO2/FiO2)、肺动态顺应性(Cdyn);于T0、T4、T8测定血浆肿瘤坏死因子α(TNF-α)、白细胞介素-8(IL-8)浓度;于实验结束时测定肺通透指数(LPI)和肺水含量。结果T1、T4、T8时LPS组与LPS+Voluven组PaO2/FiO2与Cdyn较T0时均有下降(P<0.05或P<0.01),但LPS+Voluven组高于LPS组(P<0.01);T4、T8时LPS组与LPS+Voluven组TNF-α与IL-8较T0时均有升高(P<0.01),但LPS+Voluven组低于LPS组(P<0.01);LPS组与LPS+Voluven组LPI和肺水含量大于NS组(P<0.05或P<0.01),LPS+Voluven组低于LPS组(P<0.05或P<0.01)。结论10ml/kg羟乙基淀粉130/0.4可减轻兔内毒素性急性肺损伤,抑制炎性反应可能是其机制之一。

Objective To investigate the effects of hydroxyethyl starch 130/0.4（Voluven） on lipopolysaccharide（LPS）-induced acute lung injury（ALI） in rabbits. Methods Twenty-four male New Zealand rabbits were randomly divided equally into group LPS,group LPS＋Voluven and group NS. In group LPS and group LPS＋ Voluven, the LPS-induced ALI model was reproduced by two interval venous injections of LPS. In group NS, NS was injected instead. After the second LPS/NS injection, normal saline was infused in group LPS and group NS, while Voluven 10 ml/kg was infused in an hour in group LPS＋Voluven, then normal saline was infused. PaO2/FiO2 and lung dynamic compliance （Cdyn） were recorded before the second LPS/NS injection（T0 ）, at 1 h（T1 ）, 4 h（T4 ） and 8 h（T8 ） after that. TNF-α and IL-8 were measured at T0, T4 and T8. Lung permeation index（LPI） and lung water contents were measured at the end of the experiment. Results PaO2/FiO2 and lung Cdyn were decreased at T1 ,T4 and T8 in group LPS and group LPS=Voluven（P〈0.05 or P〈0.01） ,which were higher in group LPS=Voluven than those in group LPS（P〈0.01）. TNF-α and IL-8 were increasd at T4 and T8 in group LPS and group LPS＋Voluven（P〈0.01）, which were lower in group LPS＋ Voluven than those in group LPS. LPI and lung water contents were higher in group LPS and group LPS＋Voluven than those in group NS,which were lower in group LPS＋Voluven than those in group LPS. Conclusion Hydroxyethyl starch 130/0. 4 can reduce LPS-induced ALI in rabbits and depression of inflammatory response may be one of the underlying mechanisms.