【摘要】 目的:运用不同浓度的外源性肺泡表面活性物质(Surfactant)对盐酸诱导急性肺损伤兔进行肺灌洗治疗并评价治疗效果及量效关系。方法:25只新西兰白兔用盐酸诱导造模致PaO2/FiO2<150mmHg,然后随机分成5组,每组5只,以10ml/kg的容量灌洗:生理盐水(组Ⅰ)、表面活性物质1g/L(组Ⅱ)、表面活性物质3g/L(组Ⅲ)、表面活性物质6g/L(组Ⅳ)和表面活性物质12g/L(组Ⅴ),观察用表面活性物质洗肺治疗后PaO2/FiO2、PaCO2和气道吸气峰压(PIP)的变化。结果:组Ⅲ、Ⅳ、Ⅴ在治疗后30minPaO2/FiO2、PaCO2均显著改善,3组之间没有显著差异,但PaO2/FiO2的改善不能持续3h,而PaCO2的改善不能持续2h,对于气道峰压(PIP)来说,只有组Ⅴ在30min出现显著降低但也不能持续2h。结论:用3g/L以上的表面活性物质对盐酸诱导的急性肺损伤进行肺灌洗治疗有效,可以明显改善PaO2/FiO2,但疗效的持续时间不能超过3h,而且即使采用更高浓度的3、6、12g/L的表面活性物质也不能相应提高治疗效果或延长疗效的持续时间。更多还原

【Abstract】 Objective: To evaluate the effect and dose-response relationship of surfactant replacement treatment on Hcl-induced lung injuryrabbitmodel. Methods:Lung injury was induced in adult rabbits via intratracheal injection of HCl followed by controlled ventilation(CV) until PaO2/FiO2 < 150 mmHg. Subsequently,animals were randomized into one of the five groups:(Ⅰ) control(n = 5), saline; (Ⅱ) 1g/L surfactant(n = 5);(Ⅲ) 3 g/L surfactant(n = 5); (Ⅳ) 6 g/L surfactant(n = 5);(Ⅴ)12 g/L surfactant(n = 5). All animals were studied for 4 h after therapy. Arterial blood gas analysis and PIP were observed at 1/2,1,3/2,2,3,4 h aftersurfactant treatment. Results: PaO2 increased in Ⅲ,Ⅳ,Ⅴ at 1/2 h, but did not sustain for 3 h after the injection of surfactant. PaCO2 decreased in Ⅲ,Ⅳ,Ⅴ at 1/2 h compared with Ⅰ andⅡ, but not sustained for 2 h. As to PIP, it only decreased in Ⅴ at 1/2 h and not sustained for 2 h. Conclusion: It is helpful for HCl-induced acute lung injury as long as the dose of surfactant is superior to 3 g/L, but the improvement of PaO2/FiO2 must not exceed 3 h. There are no significant differences among surfactant of 3,6 and 12 g/L.更多还原