新生儿肺出血时肺表面活性物质变化

SURFACTANT CHANGES IN NEONATAL PULMONARY HEMORRHAGE

作者等测定15例新生儿肺出血气道吸出物(TA)和13只兔肺出血模型支气管肺泡灌洗液(BALF)中肺表面活性物质(PS)的生化成分和表面活性。结果发现:肺出血时PS总磷酯(TPL)和主要成分卵磷脂(PC)、磷脂酰甘油(PG)明显减少,总蛋白(TPr)显著增高,表面活性减弱。PS活性减弱的原因可能与TPL、PC、PG的减少及蛋白质对PS的抑制有关。作者提出用外源性PS制剂治疗肺出血,可能会有一定的疗效。

The biochemical composition and the surface activities of pulmonary surfactant (PS) were determined in tracheal aspirates (TA) from 15 neonates, and bronchcalveolar lavage fluid (BALF) from 13 rabbits with pulmonary hemorrhage. In those with pulmonary hemorrhage, the total phospholipid (TPL), phosphatidylcholine (PC), phosphatidylglycerol (PG), and lecithin/sphingomyeline (L/S) ratios were decreased, but protein increased in comparison with controls. And the surface activities of hemorrhagic TA and BALF were significantly impaired. When the protein was removed from BALF or mixed phospholipids were added to BALF in rabbits with pulmonary hemorrhage, surface activities could recover. After BALF of control group was mixed with normal human plasma, the surface activities became abnormal. All of these have proved that the abnormal surface activities in pulmonary hemorrhage may be due to decrease of TPL, PC, PG and increase of PS inhibitor. Our results suggest that this inhibitor in pulmonary hemorrhage be plasma proteins and as the inhibition can be reversed, so treatment of pulmonary hemorrhage with exogenous PS may be useful.