摘要
目的 探讨PEEP对外源性肺表面活性物质（PS）功能的影响。方法 用血清将PS稀释溶解配制成4.0、24 mg/ml的实验液体。同时将PS溶解于醋酸林格液中配成相同的浓度,作为对照。实验I:设定PEEP为 0,未成熟胎兔18只随机分为2组（每组9只）:A1组,经气道内注入溶解于醋酸林格液的PS24 mg/ml;B1组,注入溶于血清的PS24 mg/ml,实验Ⅱ设定PEEP为2.5cm H2O ,未成熟胎兔24只随机分为3组（每组8只）:A2组,经气道内注入溶解于醋酸林格液的 PS4.0 mg/ml;B2组,注入溶于血清的PS4.0 mg/ml;C2组未注入任何物质。人工通气后 5、10、15、20min测定动物潮气量。结果 人工通气 20 min时,A1组动物的潮气量大于15 ml/kg,而B1组小于8.0 ml/kg（P<0.05）;A2和B2组动物的潮气量均超过20 ml/kg,而 C2组小于2.0 ml/kg。结论PEEP可以增强PS的活性,拮抗血清对PS的抑制。
Objective To examine the influence of PEEP on exogenous pulmonary surfactant (PS) function.Methods Caesarean section was performed on 26-day pregnant Japanese white rabbits (full term = 31 days) . The pre-term rabbits weighing 20-34g were anesthetized with intraperitoneal ( ip) pentobarbital sodium 0.5 mg. Tracheotomy was performed. Test liquid was prepared by suspending PS in rabbit serum or acetate Ringer solution at concentration of 4.0 or 24 mg/ml. Test liquid 10 ml/kg was instilled in lungs of PS-deficient pre-term rabbits via tracheotomy cannula. In experiment I PEEP was set at 0 cm H2O. 18 animals were randomly divided into 2 groups ( n = 9) according to the test liquid used; group A1: 24 mg/ml PS suspended in acetate Ringer solution; group B1 : 24 mg/ml PS suspended in serum; In experiment Ⅱ PEEP was set at 2.5 cm H2O. 24 animals were randomly divided into 3 groups (n =8) : group A2 : 4.0 mg/ml PS suspended in acetate Ringer solution ; group 82 : 4.0 mg/ml PS suspended in serum; group C2 : no test liquid was instilled.Rabbits were placed in plethysmograph for the measurement of tidal volume. Siemens-Elema ventilator was used for mechanical ventilation. PIP was set at 22.5 cm H2O, respiratory rate= 40 breaths/min, I: E= 1:1, FiO2 = 100% . Tidal volume was measured at 5 , 10, 15, 20 min after the start of ventilation. Results Animals in group A1 had a mean tidal volume >15 ml/kg, but in group B1 the mean tidal volume was < 8.0 ml/kg after 20 min of mechanical ventilation without PEEP(P<0.05) . Animals in group A2 and B2 had a mean tidal volume >20 ml/kg, in group C2 the tidal volume was < 2.0 ml/kg after 20 min of ventilation with 2.5 cm H2O PEEP. Conclusions PEEP can enhance PS function and antagonize inhibition of PS by serum.
出处
《中华麻醉学杂志》
CAS
CSCD
北大核心
2002年第6期348-350,共3页
Chinese Journal of Anesthesiology
关键词
呼气末正压
呼吸窘迫综合征
肺表面活性剂
治疗应用
机械通气
Positive-pressure respiration
Respiratory distress syndrome
Pulmonary surfactants
Therapeutic use
