联合雾化吸入氟碳及中药川芎嗪治疗急性肺损伤的血流动力学及组织病理的改变

Inhalation of aerosolized perfluorocarbon combined with tetramethylpyrazine ameliorates hemodynamics and pulmonary histopatholgy in a porcine model of acute lung injury

目的探讨联合雾化吸入PFC(perfluorocarbon)与中药川芎嗪治疗急性肺损伤时血流动力学及组织病理的改变。方法采用肺灌洗诱导急性肺损伤(acute lung injury,ALI)后,动物分3组:①雾化吸入PFC(perfluorocarbon group,P组)组;②联合雾化吸入PFC-川芎嗪(tetramethylpyrazine-perfluorocarbon group,TP组)组;③雾化中药川芎嗪(chinese medicial con-tral group,T组)组。分别在ALI前、灌洗后、ALI及ALI后1、2、3、4 h 7个时段观察MAP、PetCO2、mPAP、CVP以及PAWP等血流动力学指标的变化,实验结束后取肺组织做病理学分析。结果肺灌洗后3组动物MAP、mPAP、CVP以及PAWP显著升高(P>0.05),TP组治疗干预后各时段MAP、mPAP、CVP以及PAWP变化与P、T组相应时段比较具有统计学意义(P<0.05)。组织病理学显示TP组的病理改变最小,T组改变最大。结论联合雾化吸入PFC与中药川芎嗪能有效的改善氧合,显著的降低肺动脉压,减少肺组织损伤。

Objective To observe the effect of inhalation of aerosolized perfluorocarbon combined with tetramethylpyrazine on the hemodynamics and histopatholgy in a porcine model of acute lung injury.Methods Normal adult pigs were subjected to saline lavage of the bilateral lungs to induce acute lung injury and randomized subsequently into 3 groups for treatment with inhalation of perfluorocarbon,combined inhalation of perfluorocarbon and tetramethylpyrazine,or inhalation of tetramethylpyrazine.The changes of mean arterial pressure（MAP）,PetCO2,mPAP,CVP and PAWP were recorded at different time points following the lung injury,and the lung tissues were sampled for histological observations.Results The MAP,mPAP,CVP and PAWP all increased significantly in the 3 groups after acute lung injury.Interventions with combined tetramethylpyrazine and perfluorocarbon inhalation significantly improved these indices as compared with inhalation of tetramethylpyrazine or perfluorocarbon alone（P0.05）.The pulmonary pathology was the mildest in the combined inhalation group,and the most severe in tetramethylpyrazine group.Conclusion Combined inhalation of perfluorocarbon and tetramethylpyrazine can effectively improve the oxygenation,reduce pulmonary arterial pressure？and ameliorate lung pathology in pigs with acute lung injury.