【摘要】 目的探讨限制性输液对家兔内毒素性急性肺损伤的影响。方法白兔20只,随机分为2组,对照组（非限制性输液）,静脉输液12mL·kg^-1·h^-1;实验组（限制性输液）,静脉输液4mL·kg^-1·h^-1。经耳缘静脉注射内毒素,建立家兔内毒素性急性肺损伤模型,于注入内毒素后0、0.5、1、2、3h抽取动脉血行血气分析,监测动脉氧分压（arterial partial pressure of oxygen,PaO₂）,抽取静脉血离心后留取血清,待检测血栓素A-2（thromboxane A-2,TXA-2）、肿瘤坏死因子-α（tumor necrosis factor-α,TNF-α）;3h后取左下叶肺组织,做病理检查,并测量右肺组织的湿/干质量比,以反应肺水肿程度。结果静脉注射内毒素后0.5h,2组PaO₂均明显下降（P<0.05）,TXA-2、TNF-α均明显升高（P<0.05）;实验组在2h和3h时PaO₂明显高于对照组,TXA-2、TNF-α、肺组织湿/干质量比值均明显低于对照组（P<0.05）。组织学检查,对照组肺泡腔内含不等量的水肿液,红细胞,肺泡间隔毛细血管扩张充血,有炎细胞聚集、渗出;实验组肺泡腔内含少量红细胞,炎细胞聚集、渗出。结论限制性输液对内毒素致肺组织改变具有保护作用。更多还原

【Abstract】 Objective To study the effects of limited volume resuscitation on endotoxin induced acute lung injury in rabbits. Methods Twenty rabbits were randomly divided into 2 groups, control group （ non - limited volume resuscitation） , intravenous infusion 12mL·kg^-1·h^-1 ; the experimental group（limited volume resuscitation） , intravenous infusion 4mL·kg^-1·h^-1 . The endotoxin was injected by ear vein, the model of endotoxin induced acute lung injury in rabbits was established. At 0, 0.5,1, 2,3h after endotoxin injection, the arterial blood was extracted to monitor arterial partial pressure of oxygen（PaO₂） , and at the same time the venous blood was extracted, after centrifugation, the serum specimens were collected to detect thromboxane A - 2 （ TXA - 2 ） and tumor necrosis factor - a （ TNF -a）. At 3h after endotoxin injection, left lower lobe lung tissue was taken for pathological examination , and the right lung tissue wet/dry weight ratio was measured to study the lung water. Results Half an hour after intravenous injection of endotoxin, PaO₂ of the rabbits of two groups were significantly decreased （ P<0. 05 ） , TXA - 2 and TNF-α were significantly increased （ P<0. 05 ） ; compared with the control group, the PaO₂ of the experimental group were higher at 2h and 3h, and the lung wet/dry weight ratios were significantly lower （ P<0.05）. Histological examination showed in control group alveolar space contained amount of edema fluid and RBC, and the alveolar interval blood capillary was dilated and congested, with gathered, oozy inflammatory cells . But in the experimental group ,had less RBC and inflammatory cells. Conclusion Limited volume resuscitation may have a protective effect on endotoxin induced acute lung injury.更多还原