摘要
目的：探讨使用外源性肺表面活性物质（ＰＳ）治疗能否减轻烟雾吸入所致肺组织细胞损害。方法：Ｗｉｓｔａｒ大鼠随机分为５组：Ⅰ组，正常对照；Ⅱ组，烟雾吸入；Ⅲ组，烟雾＋ＰＳ＋机械通气（ＭＶ）；Ⅳ组，烟雾＋盐水＋ＭＶ；Ⅴ组，烟雾＋ＭＶ，伤后５ｍｉｎ经气管导管注入ＰＳ（１００ｍｇ／ｋｇ）或等量盐水，ＭＶ４ｈ，观察２４ｈ，检测动脉血气、肺水量、支气管肺泡灌洗液（ＢＡＬＦ）中白细胞分类计数及乳酸脱氢酶（ＬＤＨ）、血管紧张素转换酶（ＡＣＥ）和碱性磷酸酶（ＡＫＰ）活性、胎盘型碱性磷酸酶（ＰＬＡＰ）含量、肺泡壁纤维成分含量及病理检查等。结果：Ⅱ组伤后发生呼吸衰竭、肺水肿及肺部急性炎症反应，ＢＡＬＦ中ＬＤＨ、ＡＫＰ、ＡＣＥ和ＰＬＡＰ水平均明显升高，肺泡壁纤维成分含量显著减少。Ⅲ组血气较Ⅱ组明显改善，但ＢＡＬＦ中各酶水平、肺泡壁纤维成分含量及肺部炎症、水肿等无显著减轻。Ⅳ、Ⅴ组治疗无效。结论：烟雾吸入伤早期外源性ＰＳ治疗能一定程度改善呼吸功能，但对肺组织细胞损害无明显保护作用。
? Objective:To investigate whether the treatment with exogenous pulmonary surfactant (PS) could protect lung tissues and cells from the damages caused by severe smoke inhalation.Methods:Wistar rats were randomly separated into five groups: Group Ⅰ, normal control; Group Ⅱ, smoke inhalation; Group Ⅲ, smoke+PS+mechanical ventilation (MV); Group Ⅳ, smoke+saline+MV, Group Ⅴ, smoke+MV, PS (100mg/kg) or saline (same volume as PS) was instilled into the lungs via tracheal catheter at 5 min after smoke inhalation, then the animals were placed on a ventilator for 4h, and observed until 24h post injury. The arterial blood gas levels, lung water volume, the numbers and classification of white blood cells (WBC) in bronchoalvelar lavage fluid (BALF) were assayed. The activities of lactate dehydrogenase (LDH), alkaline phosphatase (AKP), angiotensinconverting enzyme (ACE), and the content of placetal alkaline phosphatase (PLAP) in BALF were measured. The pathomorphology of lung tissues, and the fiber contents of alveloar walls were also observed.Results:After smoke inhalation, the animals in group Ⅱ showed respiratory failure, serious pulmonary edema, and acute inflammatory reaction in lungs. The levels of LDH, AKP,ACE and PLAP in BALF increased markedly, the fiber contents of alveolar walls decreased dramatically. In group Ⅲ, the arterial blood gases were significantly improved compared with group Ⅱ. However, all levels of enzymes in BALF, the fiber contents of alveolar walls, the inflammatory reaction, and oedema in lungs couldnt be pronouncedly improved by PS. In group Ⅳ and Ⅴ, there were little effectiveness.Conclusion:Treatment with exogenous PS in the early stage after smoke inhalation injury improves lung function to some extent, but plays little role in protecting lung tissues and cells from damage, and has no apparent suppression effects on the secondary inflammatory reaction and acute pulmonary edema.
出处
《中国应用生理学杂志》
CAS
CSCD
1998年第1期66-69,共4页
Chinese Journal of Applied Physiology
基金
全军"九五"指令性攻关资助
关键词
肺表面活性物质
替代疗法
烧伤
吸入性
pulmonary surfactant
therapy
lactate dehydrogenase
alkaline phosphatase
angiotensinconverting enzyme
burns
inhalation
