20AA复方氨基酸联用大剂量维生素B_6对密闭舱室烟雾吸入性肺损伤救治效果研究

Effect of new therapy of 20 AA compound amino acid plus high dose of vitamin B_6 on acute lung injury induced by smoke inhalation in airtight cabins

目的探讨20AA复方氨基酸注射液(丰诺安)联用大剂量维生素B6新疗法对密闭舱室烟雾吸入性肺损伤的救治效果。方法将48只清洁级雄性SD大鼠完全随机分为正常对照组、损伤对照组及救治组,每组16只,分别为:正常对照组自由呼吸新鲜空气,腹腔注射70 mL/kg 0.9%氯化钠注射液,连续3 d;损伤对照组以只鼻染毒的方式吸入烟雾10 min后,腹腔注射70 mL/kg 0.9%氯化钠注射液,连续3 d;治疗组以口鼻染毒的方式吸入烟雾10 min后,腹腔注射50 mL/kg丰诺安注射液及50 mg/mL维生素B_6 1g/kg,连续3 d。观察死亡率,进行大鼠肺功能检测、肺大体病理观察及肺水含量测定。结果烟雾吸入后动物表现出明显的呼吸困难及精神神经症状。与损伤对照组比较,治疗组大鼠死亡率增加(60%vs 40%),两组大鼠生存时间差异无统计学意义(χ~2=0.684,P>0.05)。烟雾染毒后大鼠肺大体表现为明显的肺水肿和弥漫性出血,救治组肺出血及水肿程度轻于损伤对照组;损伤对照组大鼠肺干湿比显著高于正常对照组[(5.02±0.13)vs(4.71±0.13),P<0.01],治疗组大鼠肺干湿比显著低于损伤对照组[(4.76±0.18)vs(5.02±0.13),P<0.05];损伤组大鼠肺功能PAU显著高于正常对照组[(1.93±0.58)vs(1.33±0.17),P<0.05],治疗组大鼠PAU、EF50显著低于损伤对照组[(1.29±0.43)vs(1.93±0.58),P<0.05;(0.58±0.15)mL/sec vs(1.19±0.40)mL/sec,P<0.05]。结论丰诺安联用大剂量维生素B6能够明显缓解烟雾吸入导致肺损伤,改善肺功能,但大鼠可能由于不能耐受腹腔注射临床剂量的联用药物,从而导致死亡率增加。

Objective To evaluate the effect of a new therapy of 20 AA compound amino acid injection plus high-dose vitamin B6 on acute lung injury induced by smoke inhalation in airtight cabins.Methods A total of 48 male SD rats were randomly divided into control group,injury group and treatment group,with 16 rats per group. Rats in the control group inhaled the fresh air freely and were injected intraperitoneally with 70 mL/kg physiological saline for three days. Rats in the injury group were injected intraperitoneally with 70 mL/kg physiological saline for three days after nose-only smoke inhalation for 10 minutes. Rats in the treatment group were injected intraperitoneally with 50 mL/kg 20 AA compound amino acid injection plus 1 g/kg vitamin B_6( 50 mg/mL) for three days after nose-only smoke inhalation for 10 minutes. Survival time and poisoning manifestations,lung function,pathological changes and lung wet-to-dry weight( W/D) ratio were observed and compared in three group. Results After smoke inhalation,breathing difficulties and some mental symptoms were observed immediately. Compared with the injury group,the mortality in the treatment group was increased( 60% vs 40%),while the difference of survival time between the injury group and treatment group was not statistically significant( χ2= 0. 684,P = 0. 165).Lung edema and diffuse hemorrhage were observed in rats after smoke inhalation,and the degree of lung injury in the treatment group was lower than that in the injury group. Lung W/D ratio in the injury group was increased significantly compared with the control group [( 5. 02 ± 0. 13) vs( 4. 71 ± 0. 13),P = 0. 003].W/D ratio in the treatment group was decreased significantly compared with the injury group [( 4. 76 ±0. 18) vs( 5. 02 ± 0. 13),P = 0. 012]. PAU in the injury group was increased significantly compared with the control group [( 1. 93 ± 0. 58) vs( 1. 33 ± 0. 17),P = 0. 027]. PAU and EF50 in the treatment group were decreased significantly compared with the injury group [( 1. 29 ± 0. 43) vs( 1. 93 ± 0. 58),P = 0. 027;( 0. 58 ± 0. 15) mL/sec vs( 1. 19 ± 0. 40) mL/sec,P = 0. 035]. Conclusion The treatment of 20 AA compound amino acid injection plus high-dose vitamin B_6 can significantly improve the lung function and alleviate acute lung injury induced by smoke inhalation However,the mortality of rats is increased after smoke inhalation because of intolerance of the large dose of intraperitoneal injection of above liquids.