急性肺损伤兔改良肺部超声评分与血气变化的相关性

Correlation between modified lung ultrasound score and blood gas changes in rabbits with acute lung injury

目的 探讨急性肺损伤(ALI)兔改良肺部超声评分(MLUS)与动脉血气氧合指数(PaO2/FiO2)的相关性。方法 选取肺部超声检查无明显异常的健康新西兰雄兔20只,其中15只实验兔在超声引导下经气管注入pH值1.5、1.2、1.0 HCl溶液建立ALI模型,其余5只实验兔注入等量生理盐水(对照组)。于造模前及造模后1 h、2 h、4 h、8 h、12 h进行肺部超声、动脉血气分析获取MLUS、PaO2/FiO2,并于12 h后处死实验兔,肉眼观察肺大体组织并进行病理学检查获取病理学评分,依据病理学评分将15只实验兔分为ALI轻、中、重度组。分析MLUS与PaO2/FiO2及病理学评分的相关性。结果 参与造模的15只实验兔共获得ALI轻、中、重度组各5只。造模后随着时间的推移,ALI轻、中、重度组MLUS逐渐增高,PaO2/FiO2逐渐降低;MLUS组间两两比较差异均有统计学意义(均P<0.05);ALI轻、中、重度组造模后各时间点PaO2/FiO2均低于对照组,且重度组造模后12 h时降低幅度最大,差异均有统计学意义(均P<0.05)。ALI中、重度组病理学评分均较对照组增加,ALI重度组较轻度组增加,差异均有统计学意义(均P<0.05)。MLUS与PaO2/FiO2、病理学评分均呈强相关(r=-0.802、0.963,均P<0.05)。结论 ALI兔MLUS与PaO2/FiO2相关;MLUS标准可以半定量评估ALI程度。

Objective To explore the correlation between modified lung ultrasound score(MLUS)and arterial blood gas oxygenation index(PaO2/FiO2)in rabbits with acute lung injury(ALI).Methods Twenty healthy New Zealand male rabbits with no obvious abnormalities by lung ultrasound examination were selected,among which 15 experimental rabbits were injected with different concentrations(pH value was 1.5,1.2,1.0)of HCl via the trachea under ultrasound guidance to establish an ALI model,and the remaining 5 experimental rabbits were injected with an equal amount of saline(control group).Lung ultrasound and arterial blood gas analysis were performed before and 1 h,2 h,4 h,8 h,and 12 h after modeling,the MLUS and PaO2/FiO2 were obtained,and the experimental rabbits were killed after 12 h.Lung gross tissue was observed and pathological examination.According to the pathology,15 experimental rabbits were divided into ALI mild,moderate and severe groups.The correlation between MLUS and PaO2/FiO2 and pathological score were analyzed.Results A total of 15 modeling rabbits participating in the experiment were obtained as 5 in the ALI mild group,5 in the moderate group and 5 in the severe group.With the passage of time after modeling,the MLUS increased in the mild,moderate and severe ALI groups,and PaO2/FiO2 gradually decreased,and the differences between the MLUS in pairs were statistically significant(all P<0.05).The PaO2/FiO2 of the mild,moderate and severe ALI groups were lower than that of the control group at different time points after modeling,and the decrease of the severe group was the greatest at 12 h after modeling,and the differences were statistically significant(all P<0.05).Pathological score increased in the moderate and severe ALI group compared with the control group,and increased in the severe ALI group compared with the mild group,the differences were statistically significant(all P<0.05).The MLUS was strongly correlated with PaO2/FiO2 and the pathological score(r=-0.802,0.963,both P<0.05).Conclusion MLUS in ALI rabbits correlates with PaO2/FiO2.MLUS allows semi-quantitative assessment of ALI severity.