摘要
目的 观察获得性漏斗胸形成过程中肺功能的变化.方法 4周龄SD大鼠40只按数字随机法分为实验组和对照组各20只.实验组行经胸骨旁切断下位三对肋软骨观察漏斗胸形成,对照组不做任何干预,于术后3d和4周测定动物肺功能指标,包括：吸气阻力（Ri）、呼气阻力（Re）、肺的顺应性（Cl）、每分钟通气量（MVV）、用力肺活量（FVC）、第0.2s用力呼气容积（FEV0.2）、FEV0.2/FVC%、呼出50%FVC量时的流速（FEF50%）及用力最大呼气流速（PEF）等,检测结果在组间进行比较分析.结果 造模术后1周内动物呼吸频率增快,其后漏斗胸逐渐形成并稳定.肺功能检测：术后3d测得Ri在实验组和对照组分别为（1.16±0.21）cmH2O·ml-1·s-1和（0.73±0.26）cmH2O·ml-1·s-1 （P=0.00）,Re分别为（0.86±0.30）cmH2O·ml-1·s-1和（0.58±0.16）cmH2O·ml-1·s-1 （P=0.01）,Cl分别为（0.05±0.01）cmH2O/ml和（0.09±0.02）cmH2O/ml（P=0.00）,FVC分别为（3.69±0.10）ml和（3.89±0.19）ml （P=0.00）,FEV0.2分别为（3.28±0.40） ml和（3.58±0.15）ml（P=0.02）;术后4周测得Ri在实验组和对照组分别为（0.88±0.17） cmH2O·ml-1·s-1和（0.66±0.10）cmH2O·ml-1·s-1 （P=0.00）,FVC分别为（5.76±0.52）ml和（5.47±0.20） ml（P=0.05）.Ri在术后3d和4周的检测结果在同龄动物组间比较差异均有显著性,造模术后动物的吸气阻力增加（P〈0.05）;Re、Cl、FEV0.2和FVC等指标在术后3d的测得值组间差异有显著性,实验组Re增加而另3个指标减小（P〈0.05）,FVC在术后4周时组间比较P=0.05,而MVV 、FEV0.2/FVC%、PEF25%~75%和PEF等指标不论在术后3d还是4周的检测结果组间比较差异均无统计学意义（P〉0.05）.结论 通过胸骨旁切断下位三对肋软骨造成模型漏斗胸的形成过程中,幼鼠吸气和呼气阻力增加,胸壁和肺的顺应性均降低,随着漏斗胸的形成和稳定,肺功能重新建立适应,但胸廓的顺应性仍较正常降低.
Objective To observe the changes of lung function during forming process of acquired pectus excavatum.Methods A total of 40 4-week-old Sprague-Dawley rats were divided randomly into experimental and control groups （n=20 each）.The 5-7th couples of rib cartilage were resected parasternum for pectus excavatum model in experimental group but no intervention in control group.Pulmonary functions were detected with animal lung function analysis system at Day 3 and Week 4 after operation including the parameters of inspiratory resistance （Ri）,expiratory resistance （Re）,compliance of lung （Cl）,minute ventilation （MVV）,forced vital capacity （FVC）,forced expiratory volume in the first 0.2 seconds （FEV0.2）,FEV0.2/FVC%,exhaled 50%FVC when the quantity of flow velocity （FEF50%） and forced peak expiratory flow （PEF）.The data were compared between groups and analyzed statistically.Results There were faster respiratory rate within 1 week after operation and then funnel chest formed gradually in animal model.As a result of pulmonary function,the values of experimental and control groups at Day 3 after operation were as follows：Ri （1.16±0.21） cmH2O·ml-1·s-1 and （0.73±0.26） cmH2O·ml-1·s-1 （P=0.00）,Re （0.86±0.30） cmH2O/ml/s and （0.58±0.16） cmH2O/ml/s （P=0.01）,Cl （0.05±0.01） cmH2O/ml and （0.09±0.02） cmH2O/ml （P=0.00）,FV（3.69±0.10）ml and （3.89±0.19） ml （P=0.00）,FEV0.2 （3.28±0.40） ml and （3.58±0.15） ml （P=0.02）.And then,the values were Ri （0.88±0.17） cmH2O·ml-1·s-1 and （0.66±0.10） cmH2O·ml-1·s-1 （P=0.00）,FVC （5.76±0.52） ml and （5.47±0.20） ml （P=0.05） at Week 4.The value of Ri was higher in experimental group than that in control with statistical significance at Day 3 or Week 4 after operation （P〈0.05）.The value of Re was higher but Cl,FEV0.2 and FVC were lower in experimental group than those in control group with statistical significance at Day 3 postoperative （P〈0.05） and FVC between groups at Week 4 （P=0.05）.However,there was no statistical significance for comparing the values of MVV,FEV0.2/FVC%,PEF25-75% and PEF between groups at Day 3 or Week 4 after operation （P〉0.05）.Conclusions The compliance of chest wall and lung decreases with increased inspiratory and expiratory resistance during the forming process of model pectus.And lower thoracic compliance is maintained when pectus deformity forms but pulmonary function remains normal because of re-adaption.
出处
《中华小儿外科杂志》
CSCD
2017年第4期307-311,共5页
Chinese Journal of Pediatric Surgery
基金
国家自然科学基金（81260018）
关键词
漏斗胸
肺功能
大鼠
Pectus excavatum
Lung function
Rat
