CAJ | 학술논문

目的建立单肺通气诱发兔急性肺损伤模型.方法清洁级健康新西兰白兔16只,体重2.3～2.7 kg,采用随机数字表法,将兔随机分为VT 6 ml/kg组(Ⅰ组)和VT 12 ml/kg组(Ⅱ组),每组8只.气管切开插入单腔气管导管行右侧单肺通气,Ⅰ组和Ⅱ组VT分别为6、12 ml/kg,余通气参数均为FiO2 50%.通气频率40次/min,I∶E为1∶2.于单肺通气前即刻(T0)、单肺通气1、2、3 h(T1-3)时记录气道峰压,采集动脉血行血气分析,计算氧合指数;于单肺通气3 h时处死动物,取肺组织,观察病理学结果,行肺损伤评分,计算肺湿/干重比,测定左、右支气管肺泡灌洗液蛋白浓度,计数中性粒细胞.结果与T0时比较,Ⅱ组T1～3,时气道峰压升高,两组T2,3时氧合指数降低(P＜0.05);与左肺比较,两组右肺湿/干重比和肺损伤评分降低(P＜0.05);与Ⅰ组比较,Ⅱ组T1～3,时气道峰压升高,T3时氧合指数降低,右肺湿/干重比、支气管肺泡灌洗液蛋白浓度、中性粒细胞计数及肺损伤评分升高(P＜0.05).结论采用VT 12 ml/kg单肺通气3 h成功建立了兔急性肺损伤模型.
목적 건립단폐통기유발토급성폐손상모형.방법 청길급건강신서란백토16지,체중2.3～2.7 kg,채용수궤수자표법,장토수궤분위VT 6 ml/kg조(Ⅰ조)화VT 12 ml/kg조(Ⅱ조),매조8지.기관절개삽입단강기관도관행우측단폐통기,Ⅰ조화Ⅱ조VT분별위6、12 ml/kg,여통기삼수균위FiO2 50%.통기빈솔40차/min,I∶E위1∶2.우단폐통기전즉각(T0)、단폐통기1、2、3 h(T1-3)시기록기도봉압,채집동맥혈행혈기분석,계산양합지수;우단폐통기3 h시처사동물,취폐조직,관찰병이학결과,행폐손상평분,계산폐습/간중비,측정좌、우지기관폐포관세액단백농도,계수중성립세포.결과 여T0시비교,Ⅱ조T1～3,시기도봉압승고,량조T2,3시양합지수강저(P＜0.05);여좌폐비교,량조우폐습/간중비화폐손상평분강저(P＜0.05);여Ⅰ조비교,Ⅱ조T1～3,시기도봉압승고,T3시양합지수강저,우폐습/간중비、지기관폐포관세액단백농도、중성립세포계수급폐손상평분승고(P＜0.05).결론 채용VT 12 ml/kg단폐통기3 h성공건립료토급성폐손상모형.
Objective To establish a rabbit model of acute lung injury induced by one-lung ventilation (OLV) .Methods Sixteen New Zealand white rabbits weighing 2.3-2.7 kg were randomly divided into 2 groups (n=8 each):conventional tidal volume(VT) group (group Ⅰ) and high VT group (group Ⅱ).All the rabbits were tracheostomized and a tracheal tube was inserted into the right bronchus for right lung ventilation in the two groups. VT was set at 6 ml/kg in group Ⅰ and at 12 ml/kg in group Ⅱ and the other ventilatory parameters were the same in the two groups (FiO2 50% , RR 40 bpm, I∶E=1∶2). Immediately before OLV(T0) and at 1, 2 and 3 h of OLV (T1-3), peak airway pressure was measured and arterial blood samples were taken for blood gas analysis and oxygenation index (OI) was calculated. The animals were sacrificed at 3 h of OLV and lung tissues obtained for microscopic examination.The lung injury was scored. W/D lung weight ratio was calculated. Bron-choalveolar lavage fluid (BALF) was collected for measurement of protein concentrations and neutrophil counts. Results The peak airway pressure was significantly higher at T1-3 in group Ⅱ and OI was significantly lower at T2,3 in the two groups than those at T0(P＜0.05) .W/D lung weight ratio and lung injury scores of the right lung were significantly lower than those of the left lung in the two groups(P＜0.05).The peak airway pressure was significantly higher at T1-3, OI was significantly lower at T3, and W/D lung weight ratio, protein concentrations and neutrophil counts in BALF and lung injury scores of the right lung were significantly higher in group Ⅱ than in group Ⅰ(P＜0.05). Conclusion OLV with VT of 12 ml/kg for 3 h can successfully establish a rabbit model of acute lung injury.