烟雾吸入伤后肺表面活性物质活性与蛋白的关系(论著)

Relationship between the activity of pulmonary surfactant and plasma proteins after smoke inhalation

目的：探讨急性烟雾吸入伤后肺表面活性物质（ＰＳ）功能活性抑制与蛋白的关系。方法：采用大鼠烟雾吸入伤模型，分别检测了正常对照及致伤２、６、１２和２４小时动物的静态肺顺应性、支气管肺泡灌洗液（ＢＡＬＦ）表面张力活性、ＢＡＬＦ中超氧化歧化酶活性、丙二醛、总蛋白（ＴＰ）、总磷脂（ＴＰＬ）、纤维蛋白原（Ｆｉｇ）和纤维蛋白（原）降解产物（ＦＤＰ）含量。结果：动物伤后肺顺应性显著降低；ＢＡＬＦ的最小表面张力进行性升高。滞后环面积、稳定指数和恢复系数进行性下降，ＢＡＬＦ中ＴＰ、ＴＰＬ、Ｆｉｇ和ＦＤＰ水平均明显升高，最小表面张力和肺顺应性的变化与ＴＰ／ＴＰＬ比值的改变相关显著。结论：血浆蛋白、特别是Ｆｉｇ和ＦＤＰ的抑制作用可能是烟雾吸入伤后继发性ＰＳ功能活性降低的主要原因之一。

Aim:To evaluate the relationship between the activity of pulmonary surfactant(PS) and plasma proteins after acute smoke inhalation injury.Methods:With the use of a rat smoke inhalation injury model,the static lung compliance,the surface tension and superoxide dismutase activities of bronchoalveolar lavage fluid(BALF),the contents of malondialdehyde,total protein(TP),total phospholipids(TPL),fibrinogen(Fig) and fibrin(fibrinogen)degradation products(FDP)were determined in normal control and injured animals at 2 h,6 h,12 h and 24 h respectively after injury.Results:After smoke inhalation,the static lung compliance decreased dramatically.The minimum surface tension(STmin)of BALF increased,while its hysteresis area,stability index and recruitment index decreased progressively.The contents of TP,TPL,Fig and FDP in BALF increased markedly.There were significant correlations between the changes of TP/TPL ratio and the changes of STmin and static lung compliance.Conclusion:The inhibitory effect of plasma proteins,especially the Fig and FDP,could be one of the main causes of the decrease of secondary PS functional activity after smoke inhalation injury.