吸入一氧化氮及静注异丙酚治疗兔油酸型急性肺损伤

Nitric oxide inhalation and propofol injection in treatment of rabbits with oleic acid-induced acute lung injury

目的 观察吸入NO、静注异丙酚改善兔油酸型急性肺损伤 (ALI)的氧合效果。方法 用 6 0mg·kg- 1油酸引发兔ALI后 (0h) ,随机分组。模型组 (n =5 ) :单纯行机械通气 ;NO组 (n =5 ) :持续吸入2 0ppmNO;异丙酚组 (n =5 ) :静注异丙酚2mg·kg- 1·h- 1。观察基础状态、0h、2h的平均动脉压 (SAP)、HR、动脉血气及肺功能变化。治疗结束后摄胸片 ,测定肺组织湿 /干 (W/D)比值。结果 治疗2h后与模型组相比 ,NO组PaO2 >95mmHg,(P <0 .0 1)、PaO2 /FiO2 >30 0 ,明显提高 (P <0 .0 5 )、Qs/Qt、W /D显著下降 (P <0 .0 5 ) ,异丙酚组无改变。结论 急性肺损伤早期吸入NO可以安全有效地改善肺循环 ,提高氧合 ,减轻肺水肿 ,延缓肺损伤进程 ;

Aim To observe effects of inhalation of nitric oxide and intravenous propfol on pulmonary oxygenation and perfusion in rabbits with acute lung injury (ALI) induced by oleic acid. Methods Nineteen healthy adult rabbits were anesthetized with tracheotomy, and then ventilated mechanically. Four animals were selected as normal control. The others were induced into ALI( 0 h ) by pulmonary injection of oleic acid ( 60 mg·kg -1 ) and then randomly allocated into three groups: (1) control group (n=5, receiving ventilation only); (2) NO group (n=5, inhaling NO at 20 ppm ); and (3) propofol group(n=5, receiving intravenous propofol 2 mg·kg -1 ·h -1 ). The mean systemic arterial pressure (SAP), heart rate (HR), PaO 2, PaCO 2 and Qs/Qt were recorded in the time of baseline, 0 h and 2 h . X rays of chests were given and wet to dry lung weight ratio (W/D) was determined after the treatment. Results 2 h after the administration, the mean PaO 2 (> 95 mmHg , P< 0.05 ) and PaO 2/ FiO 2(>300, P< 0.05 ) were significantly improved and Qs/Qt (16%, P< 0.05 ), W/D reduced significantly in the NO group, but not in the propofol group. Conclusion NO inhalation, used for ALI in early stage, can safely and effectively improve pulmonary circulation, gas exchange, pulmonary oxygenation and perfusion, decrease pulmonary edema, and slow down the progress of lung injury. Propofol does not show any influence on oxygenation and pulmonary arterial pressure.