肺表面活性物质治疗大鼠小肠缺血再灌注所致肺损伤

Exogenous pulmonary surfactant therapy in acute lung injury induced by intestinal ischemia-reperfusion in mice

目的 了解外源性肺表面活性物质 (PS)对小肠缺血再灌注所致肺损伤的治疗效果。方法 正常雄性SD大鼠 2 7只 ,腹腔麻醉后随机分为 3组 (n =9) ,A组 :钳夹肠系膜上动脉 10s作为对照 ;B组 :阻断动脉 1h后 ,去除阻断 ,形成再灌注 2h ;C组 :模型制作同B组 ,PS以 10 0mg/kg气道滴入。所有动物再机械通气 2h。监测动脉血气 (PaO2 )、肺顺应性 (Cdyn)和气道阻力 (R)和病理改变。结果 血气分析B组PaO2 进行性降低 (B组与A组比较 ,P <0 .0 5 ) ,C组PS治疗后PaO2 较为稳定 ,不表现为进行性下降 ,12 0min时较病变组差异有显著性意义 (C组与B组比较 ,P <0 .0 5 ) ,肺功能表现为B组Cdyn降低、R升高 ,治疗后Cdyn稳定 ,12 0min时略有升高 (C组与B组比较 ,P <0 .0 5 ) ,病理观察 :B组肺水肿、间质出血、炎性细胞浸润及部分肺不张 ,C组治疗后病变减轻。

Objective To study the effects of exogenous pulmonary surfactant(PS) on acute lung injury induced by intestinal ischemia reperfusion in mice.Methods Twenty seven healthy SD mice were anesthetized and divided equally into 3 groups at random, namely : Group A transient occlusion of mesenteric artery for 10 seconds as sham control; Group B occlusion of the artery for 1h followed by 2?h reperfusion ; Group C intratracheal injection of PS (100mg/kg). All mice were tracheotomized and ventilated mechanically after the initial 3?h, pH, dynamic compliance(Cdyn), and resistance(R) were measured simultaneously. Results 1. Pathological examination showed that the lung edema, hemorrhage and partial atelectasis were found in group B. All of these features were reversed by PS in group C;2. The gas exchange function was damaged in group B ( lower PaO 2 and higher PaCO 2, B vs A, P < 0.05 ). After using PS, PaO 2 was improved and PaCO 2 decreased (C vs B, P < 0.05 ); 3. The lung function of group B also showed decreasing in Cdyn and increasing in R. Cdyn in group C was obvious better than that in group B. Conclusion PS is an effective therapy in animal models of acute lung injury.