短暂性高原因素对光气中毒兔急性肺损伤的影响

Effects of transient plateau factor on acute lung injury induced by phosgene poisoning in rabbits

目的 评价短暂性高原因素对光气中毒兔急性肺损伤的影响.方法 新西兰大白兔40只,雌雄不拘,体重2.0～ 2.5 kg,采用随机数字表法,随机分为4组（n=10）：对照组（C组）;高原因素组（H组）低压低氧2h;光气中毒组（P组）吸入光气3 min;高原光气中毒组（HP组）吸入光气3 rin后低压低氧2h.于中毒前（L）、中毒后（T2）、低压低氧后即刻（T3）、1 h（T4）和6 h（T5）时测定RR及PaO2,计算氧合指数（OI）;于T5时取肺组织标本,测定肺水含量（LW）并计算肺系数（LC）,光镜下观察肺组织病理学结果.结果 与C组比较,H组T3时RR升高,P组及HP组T2-5时RR升高,Ol降低,LW和LC增加（P＜0.05或0.01）;与P组比较,HP组T3-5时RR升高,OI降低,LW和LC增加（P＜0.05或0.01）,P组及HP组肺组织发生病理性改变,而HP组的程度较重.结论 短暂性高原因素可明显加重光气中毒兔急性肺损伤的程度.

Objective To investigate the effects of transient plateau factor on acute lung injury induced by phosgene poisoning in rabbits.Methods Forty New Zealand white rabbits of both sexes,aged 2.0-2.5 kg,were randomly divided into 4 groups （n =10 each） using a random number table：control group （group C）,plateau factor group （group H）,phosgene poisoning group （group P）,and phosgene poisoning and plateau factor group （group HP）.In group H,the rabbits were exposed to a simulated altitude of 33000 m for 2 h.In group P,the rabbits were exposed to phosgene for 3 min only.In group HP,the rabbits were exposed to phosgene for 33 min and then to a simulated altitude of 3000 m for 2 h.Respiratory rate （RR） was recorded and blood samples were taken before exposure to phosgene （T1）,after exposure to phosgene （T2）,and at 0,1 and 6 h after onset of exposure to a simulated altitude of 33000 m （T3-5） for determination of PaO2 and oxygenation index （OI） was calculated.The chests were opened at T5 and lungs removed for determination of lung water content （LC） and for microscopic examination.Lung coefficient （LC） was calculated.Results Compared with C group,RR was significantly increased at T3 in group H （P ＜ 0.05）,and RR was increased and OI was decreased at T2-5 in P and HP groups （P ＜ 0.05 or 0.01）.Compared with P group,RR was increased and OI was decreased at T3-5 in HP group （P ＜ 0.05 or 0.01）.LW and LC were significantly higher in P and HP groups than in group C,and in HP group than in group P （P ＜ 0.05 or 0.01）.The microscopic examination showed that pathological changes were observed in P and HP groups,however,the changes were severer in HP group.Conclusion Transient plateau factor can obviously aggravate the degree of acute lung injury induced by phosgene poisoning in rabbits.