中华妇幼临床医学杂志（电子版）
中華婦幼臨床醫學雜誌（電子版）
중화부유림상의학잡지（전자판）
CHINESE JOURNAL OF OBSTETRICS & GYNECOLOGY AND PEDIATRICS(ELECTRONIC VERSION)
2012年
2期
168-172
,共5页
王少华%黄斌%许峰%匡风梧
王少華%黃斌%許峰%劻風梧
왕소화%황빈%허봉%광풍오
急性呼吸窘迫综合征%一氧化氮供体%雾化吸人硝普钠%肺动脉高压%细胞因子%新生猪
急性呼吸窘迫綜閤徵%一氧化氮供體%霧化吸人硝普鈉%肺動脈高壓%細胞因子%新生豬
급성호흡군박종합정%일양화담공체%무화흡인초보납%폐동맥고압%세포인자%신생저
acute respiratory distress syndrome%nitrogen monoxidum donor%nebulized sodium nitroprusside%pulmonary hypertension%cytokine%newborn piglet
目的 探讨雾化吸人(neb)一氧化氮(NO)供体硝普钠(SNP) (neb SNP)对新生猪急性呼吸窘迫综合征(ARDS)的疗效、安全性及实验依据.方法 采用生理盐水(NS)肺泡灌洗法复制ARDS新生猪模型(n=30).造模成功后将其随机分成5组(n=6×5).对照组:仅机械通气治疗;NS组:机械通气治疗+neb-NS 30 min治疗;A,B和C组为实验组,分别进行机械通气治疗+neb-SNP 1 mg/mL,5 mg/mL和10 mg/mL 30 min治疗.对5组分别于不同时点进行动态平均股动脉压(MAP)、平均肺动脉压(MPAP)、全血高铁血红蛋白(MetHb)含量监测及动脉血气分析和细胞因子[肿瘤坏死因子(TNF)-α与白细胞介素(IL)-10,-12]水平测定.结果 造模成功时,NS组及A,B,C组MPAP均显著高于对照组,差异有统计学意义(P＜0.01);neb结束时,B及C组MPAP较NS组显著下降,差异有统计学意义(P＜0.05).在相同时点,5组MAP比较,差异无统计学意义(P＞0.05).neb结束时,5组全血MetHb含量比较,差异无统计学意义(P＞0.05).A,B及C组neb结束后30 min,未发现反跳性肺动脉高压.neb结束后不同时点,A,B及C组与对照组及NS组IL-10,-12,TNF-α比较,差异有统计学意义(P＜0.05),而B与C组比较,差异无统计学意义(P＞0.05).结论 neb-SNP可选择性降低ARDS模型肺动脉高压,同时具有调节炎症介质和抗炎因子等作用,可抑制炎症因子表达,从而减轻ARDS症状.
目的 探討霧化吸人(neb)一氧化氮(NO)供體硝普鈉(SNP) (neb SNP)對新生豬急性呼吸窘迫綜閤徵(ARDS)的療效、安全性及實驗依據.方法 採用生理鹽水(NS)肺泡灌洗法複製ARDS新生豬模型(n=30).造模成功後將其隨機分成5組(n=6×5).對照組:僅機械通氣治療;NS組:機械通氣治療+neb-NS 30 min治療;A,B和C組為實驗組,分彆進行機械通氣治療+neb-SNP 1 mg/mL,5 mg/mL和10 mg/mL 30 min治療.對5組分彆于不同時點進行動態平均股動脈壓(MAP)、平均肺動脈壓(MPAP)、全血高鐵血紅蛋白(MetHb)含量鑑測及動脈血氣分析和細胞因子[腫瘤壞死因子(TNF)-α與白細胞介素(IL)-10,-12]水平測定.結果 造模成功時,NS組及A,B,C組MPAP均顯著高于對照組,差異有統計學意義(P＜0.01);neb結束時,B及C組MPAP較NS組顯著下降,差異有統計學意義(P＜0.05).在相同時點,5組MAP比較,差異無統計學意義(P＞0.05).neb結束時,5組全血MetHb含量比較,差異無統計學意義(P＞0.05).A,B及C組neb結束後30 min,未髮現反跳性肺動脈高壓.neb結束後不同時點,A,B及C組與對照組及NS組IL-10,-12,TNF-α比較,差異有統計學意義(P＜0.05),而B與C組比較,差異無統計學意義(P＞0.05).結論 neb-SNP可選擇性降低ARDS模型肺動脈高壓,同時具有調節炎癥介質和抗炎因子等作用,可抑製炎癥因子錶達,從而減輕ARDS癥狀.
목적 탐토무화흡인(neb)일양화담(NO)공체초보납(SNP) (neb SNP)대신생저급성호흡군박종합정(ARDS)적료효、안전성급실험의거.방법 채용생리염수(NS)폐포관세법복제ARDS신생저모형(n=30).조모성공후장기수궤분성5조(n=6×5).대조조:부궤계통기치료;NS조:궤계통기치료+neb-NS 30 min치료;A,B화C조위실험조,분별진행궤계통기치료+neb-SNP 1 mg/mL,5 mg/mL화10 mg/mL 30 min치료.대5조분별우불동시점진행동태평균고동맥압(MAP)、평균폐동맥압(MPAP)、전혈고철혈홍단백(MetHb)함량감측급동맥혈기분석화세포인자[종류배사인자(TNF)-α여백세포개소(IL)-10,-12]수평측정.결과 조모성공시,NS조급A,B,C조MPAP균현저고우대조조,차이유통계학의의(P＜0.01);neb결속시,B급C조MPAP교NS조현저하강,차이유통계학의의(P＜0.05).재상동시점,5조MAP비교,차이무통계학의의(P＞0.05).neb결속시,5조전혈MetHb함량비교,차이무통계학의의(P＞0.05).A,B급C조neb결속후30 min,미발현반도성폐동맥고압.neb결속후불동시점,A,B급C조여대조조급NS조IL-10,-12,TNF-α비교,차이유통계학의의(P＜0.05),이B여C조비교,차이무통계학의의(P＞0.05).결론 neb-SNP가선택성강저ARDS모형폐동맥고압,동시구유조절염증개질화항염인자등작용,가억제염증인자표체,종이감경ARDS증상.
Objective To observe the effects of nebulized (neb) nitrogen monoxidum(NO) donors sodium nitroprusside (SNP)(neb-SNP)on acute respiratory distress syndrome(ARDS) in newborn piglets.Methods Thirty anesthetized and mechanically ventilated piglets were randomly divided into five groups (n=6× 5):①Control group; ②Group NS,receiving neb normal sodium(NS) after ARDS ;③ Group A,B,and C(neb-SNP),receiving 1 mg/mL,5 mg/mL and 10 mg/mL neb-SNP after ARDS,respectively.Mean arterial pressure(MAP) and mean pulmonary arterial pressure (MPAP) were monitored continuously.Arterial blood gas analysis was determined at baseline,termination of neb-SNP and 30 min,60 min,120 min after neb,and blood methemoglobin (MetHb) were monitored.Tumor necrosis factor(TNF)-α,interleukin (IL)-10,12 concentration in serum at 30 min,60 min and 120 min after neb were measured.Results ARDS resulted in a significant increase in MPAP,MPAP in group NS,group A,B and C were significantly higher than that in control group (P＜0.01).After neb,MPAP in group B and C were significantly lower than that in group NS(P＜0.05).There was no significant difference in MAP among five groups at the same time points (P＞0.05).After neb,there were no significant differences in blood MetHb level among five groups.No rebound pulmonary hypertension was observed after withdrawal of neb.Serum concentrations of TNF-α and IL-12 in group A,B and C (the neb-SNP treated group) were more decreased than those in control group and group NS,and serum IL-10 concentration was obviously increased in group A,B and C.Conclusions neb-SNP could be used as a selective pulmonary vasodilator for acute pulmonary hypertension induced by ARDS in newborn piglets.Reduced lung injury induced by ARDS through lowering and inhibiting expression of harmful inflammatory cytokines.
