目的 通過(guò)全氟化碳( PFC) 汽化吸入治療ALI 兔模型, 探討全氟化碳汽化吸入對(duì)ALI動(dòng)物肺、小腸、肝、腎病理組織學(xué)的影響及意義。方法 將18 只新西蘭兔隨機(jī)分為三組: 常規(guī)通氣組( CMV組) 、PFC 汽化吸入組( PFC 組) 及對(duì)照組。將兔氣管切開, 插管連接呼吸機(jī)進(jìn)行機(jī)械通氣, 通過(guò)人工海水氣管內(nèi)注入制作ALI 模型后, CMV 組給予常規(guī)通氣6 h, PFC 組給予汽化吸入PFC 治療2 h后調(diào)整為常規(guī)通氣觀察4 h, 對(duì)照組撤除呼吸機(jī)。實(shí)驗(yàn)結(jié)束后將各組動(dòng)物肺、小腸、肝、腎進(jìn)行固定、包埋和切片, 光鏡下進(jìn)行組織病理學(xué)評(píng)分。結(jié)果 對(duì)照組兔在撤離呼吸機(jī)15 min 內(nèi)全部死亡。PFC 組氧合指數(shù)在治療和后續(xù)觀察期內(nèi)持續(xù)改善, 明顯高于CMV 組。與CMV 組比較, 汽化吸入PFC 能明顯減輕肺組織的病理?yè)p傷( 5. 283 ±0. 679 比9. 833 ±0. 753, P lt;0. 05) ; 肝( 0. 683 ±0. 133 比1. 100 ±0. 580) 、腎( 0. 767 ±0. 484 比0. 883 ±0. 240) 和小腸( 0.500 ±0. 190 比0. 750 ±0. 521) 的病理?yè)p傷雖然呈現(xiàn)出減輕的趨勢(shì), 但差異無(wú)統(tǒng)計(jì)學(xué)意義。結(jié)論 汽化吸入PFC 在改善氧合的同時(shí), 能明顯減輕肺組織的病理?yè)p傷, 但不能證實(shí)對(duì)肺外器官有明顯保護(hù)作用。
引用本文: 韓丙超,解立新,趙曉巍,黃賢. 全氟化碳汽化吸入對(duì)急性肺損傷兔多臟器病理組織學(xué)的影響. 中國(guó)呼吸與危重監(jiān)護(hù)雜志, 2009, 09(2): 171-175. doi: 復(fù)制
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- 1. 錢桂生. 在實(shí)踐中提高對(duì)急性肺損傷和急性呼吸窘迫綜合征新概念的認(rèn)識(shí). 中國(guó)呼吸與危重監(jiān)護(hù)雜志, 2002, 1: 199-201.
- 2. Gregor T, Schmalisch G, Burkhardt W, et a1 . Aerosolization of perfluorocarbons during mechanical ventilation: an in vitro study.Intensive Care Med, 2003, 29: l354-1360.
- 3. 黃志堅(jiān), 李琦, 王長(zhǎng)征, 等. 全氟化碳霧化吸入對(duì)兔急性肺損傷肺組織結(jié)構(gòu)及抗炎作用的影響. 中國(guó)呼吸與危重監(jiān)護(hù)雜志,2007, 6: 45-48.
- 4. 樊毫軍, 張健鵬, 劉又寧. 吸入全氟化碳治療急性肺損傷研究進(jìn)展. 中國(guó)呼吸與危重監(jiān)護(hù)雜志, 2006, 5: 63-65.
- 5. Koch T, Ragaller M, Haufe D, et al. Perfluorohexane attenuates proinflammatory and procoagulatory response of activated monocytes and alveolar macrophages. Anesthesiology, 2001, 94: 101-109.
- 6. Derks CM, Jacoboritz-Derks D. Embolic pneumopathy induced by oleic acid. Am J Pathol, 1977, 87: 143.
- 7. Schlag G, Redl H, van Vuuren CJ, et al. Hyperdynamic sepsis in baboonsⅡ : relation of organ damage to severity of sepsis evaluated by a newly developed morphological scoring system. Circ Shock,1992, 38: 253-263.
- 8. Zhang XP, Zhang L, Wang Y, et al. Study of the protective effects of dexamethasone on multiple organ injury in rats with severe acute pancreatitis. JOP, 2007, 8: 400-412.
- 9. Haeberle HA, Nesti F, Dieteilch HJ, et al. Perllubron reduces lung inflammation in respimtory syncytial virus infection by inhibiting chemokine expression and nuclear factor-kappa B activation. Am J Respir Crit Care Med, 2002, 165: 1433-1438.
- 10. 劉書盈, 樊毫軍, 錢桂生, 等. 全氟化碳腹腔注射對(duì)內(nèi)毒素肺損傷大鼠中性粒細(xì)胞肺浸潤(rùn)的抑制作用. 中華結(jié)核和呼吸雜志,2006, 29: 674-678.