低分子右旋糖酐与地塞米松预防脂肪栓塞综合征的实验研究

Preventive effect of dexamethasone and low-molecular-weight dextran on fat embolism syndrome in rats

目的探讨药物预防脂肪栓塞综合征(FES)的效果与机制。方法雄性Wistar大鼠80只,随机分成低分子右旋糖酐组(A组)、地塞米松组(B组)、地塞米松与低分子右旋糖酐联用组(C组)及空白对照组(D组),每组20只。均采用油酸静脉注射诱发FES,于药物注射后1、2、3、4小时各取5只大鼠行动脉血氧分压(PaO2)、肺组织肿瘤坏死因子-α(TNF-α)及髓过氧化物酶(MPO)测定,取4小时时肺组织进行病理学检查。结果随时间的延长,各用药组初期下降的PaO2呈逐渐上升趋势,TNF-α与MPO值明显低于D组,肺部FES病理改变减轻。C组作用最强,B组作用强于A组。结论地塞米松与低分子右旋糖酐均可预防大鼠FES,联合用药作用最强,地塞米松次之,阻断FES的多个病理过程是联合用药的作用机制。

Objective To investigate the preventive effect and the mechanism of drugs on fat embolism syndrome（FES）.Methods A total of 80 Wistar rats were randomly divided into four experimental groups（20 rats in each group）： low-molecular-weight dextran group（Group A）,dexamethasone group（Group B）,dexamethasone combined with low-molecular-weight dextran group（Group C）,control group（Group D）.FES models were produced by injection of oleic acid.Arterial PaO2,pulmonary tumour necrosis factor（TNF-α） and myeloperoxidase（MPO） were examined at 1,2,3,4 hours after various chemoprophylaxis.The pulmonary histopathological changes were observed at 4 hours.Results In all chemoprophylaxis groups,the descended level of PaO2 was increasing steadily with time prolongation,the level of TNF-α and MPO in lung was lower than that in group D and the pulmonary histological changes were smaller than those in group D.In all the groups,the preventive effect in Group C was strongest,Group B took the second place.Conclusion Effective preventions on FES could be achieved by application of dexamethasone and low-molecular-weight dextran.Of them,the combined use of the two drugs,which may interrupt multiple pathological procedures in FES,has the strongest preventive effect,followed by dexamethasone.