中华危重病急救医学
中華危重病急救醫學
중화위중병급구의학
Chinese Critical Care Medicine
2014年
6期
394-398
,共5页
兰超%李海娜%李莉%王金柱%李璐%苏倩倩%车璐%刘兰萍%狄敏
蘭超%李海娜%李莉%王金柱%李璐%囌倩倩%車璐%劉蘭萍%狄敏
란초%리해나%리리%왕금주%리로%소천천%차로%류란평%적민
中毒,百草枯%急性肺损伤%猪%动物模型%脉搏指示连续心排血量监测
中毒,百草枯%急性肺損傷%豬%動物模型%脈搏指示連續心排血量鑑測
중독,백초고%급성폐손상%저%동물모형%맥박지시련속심배혈량감측
Paraquat poisoning%Acute lung injury%Piglet%Model%Pulse-indicated continuous cardiac output monitor
目的 建立百草枯(PQ)致家猪急性肺损伤(ALI)模型.方法 将10头健康雌性家猪按随机数字表法分为对照组(n=4)和实验组(n=6).实验组家猪腹腔注射20% PQ溶液20 mL制备ALI模型;对照组给予等量生理盐水.用脉搏指示连续心排血量(PiCCO2)监测仪动态监测动物心率(HR)、平均动脉压(MAP)、血管外肺水指数(EV LWI)、肺血管通透性指数(PVPI),记录动脉血pH值、动脉血氧分压(PaO2)、动脉血二氧化碳分压(PaCO2)、氧合指数(PaOJFiO2),以及气道峰压(PIP)、气道平台压(Pplat),每0.5 h测定1次,直到PaOJFiO2≤300 mmHg(1 mmHg=0.133 kPa).制模成功时显微镜下观察肺组织病理学改变.结果 实验组5头猪成功建立ALI模型,平均制模成功时间为(4.5±0.2)h.实验组染毒后HR、MAP、EVLWI、PVPI、PIP和Pplat均呈上升趋势,制模成功时各指标明显高于对照组[HR(次/min):132.0±6.9比113.0±3.4,t=-21.632,P=0.000; MAP(mmHg):114.0±6.0比98.0±3.5,t=-18.217,P=0.000; EVLWI(mUkg):19.2±2.8比12.5±1.2,t=-76.283,P=0.000; PVPI:5.9±1.3比3.1±0.4,t=-31.879,P=0.000; PIP(cmH2O,1 cmH2O=0.098 kPa):25.4±2.5比18.6±1.5,t=-77.421,P=0.000;Pplat(cmH2O):19.6±2.2比13.5±1.7,t=-69.452,P=0.000].实验组染毒后pH值、PaO2及PaO2/FiO2均呈下降趋势,而PaCO2逐渐上升,制模成功时血气分析指标与对照组比较差异均有统计学意义[pH值:7.35±0.04比7.43±0.05,t=9.108,P=0.000; PaO2(mmHg):82.0±7.4比172.0± 11.6,t=102.470,P=0.000; PaCO2(mmHg):44.0±4.0比35.0±2.0,t=-10.217,P=0.000; PaOjFiO2(mmHg):273.0±14.8比573.0±22.5,t=341.565,P=0.000].肺组织病理结果显示,制模成功时肺组织出现明显的损伤性改变.结论 采用腹腔注射20% PQ溶液20 mL可以建立稳定的PQ致猪ALI模型.
目的 建立百草枯(PQ)緻傢豬急性肺損傷(ALI)模型.方法 將10頭健康雌性傢豬按隨機數字錶法分為對照組(n=4)和實驗組(n=6).實驗組傢豬腹腔註射20% PQ溶液20 mL製備ALI模型;對照組給予等量生理鹽水.用脈搏指示連續心排血量(PiCCO2)鑑測儀動態鑑測動物心率(HR)、平均動脈壓(MAP)、血管外肺水指數(EV LWI)、肺血管通透性指數(PVPI),記錄動脈血pH值、動脈血氧分壓(PaO2)、動脈血二氧化碳分壓(PaCO2)、氧閤指數(PaOJFiO2),以及氣道峰壓(PIP)、氣道平檯壓(Pplat),每0.5 h測定1次,直到PaOJFiO2≤300 mmHg(1 mmHg=0.133 kPa).製模成功時顯微鏡下觀察肺組織病理學改變.結果 實驗組5頭豬成功建立ALI模型,平均製模成功時間為(4.5±0.2)h.實驗組染毒後HR、MAP、EVLWI、PVPI、PIP和Pplat均呈上升趨勢,製模成功時各指標明顯高于對照組[HR(次/min):132.0±6.9比113.0±3.4,t=-21.632,P=0.000; MAP(mmHg):114.0±6.0比98.0±3.5,t=-18.217,P=0.000; EVLWI(mUkg):19.2±2.8比12.5±1.2,t=-76.283,P=0.000; PVPI:5.9±1.3比3.1±0.4,t=-31.879,P=0.000; PIP(cmH2O,1 cmH2O=0.098 kPa):25.4±2.5比18.6±1.5,t=-77.421,P=0.000;Pplat(cmH2O):19.6±2.2比13.5±1.7,t=-69.452,P=0.000].實驗組染毒後pH值、PaO2及PaO2/FiO2均呈下降趨勢,而PaCO2逐漸上升,製模成功時血氣分析指標與對照組比較差異均有統計學意義[pH值:7.35±0.04比7.43±0.05,t=9.108,P=0.000; PaO2(mmHg):82.0±7.4比172.0± 11.6,t=102.470,P=0.000; PaCO2(mmHg):44.0±4.0比35.0±2.0,t=-10.217,P=0.000; PaOjFiO2(mmHg):273.0±14.8比573.0±22.5,t=341.565,P=0.000].肺組織病理結果顯示,製模成功時肺組織齣現明顯的損傷性改變.結論 採用腹腔註射20% PQ溶液20 mL可以建立穩定的PQ緻豬ALI模型.
목적 건립백초고(PQ)치가저급성폐손상(ALI)모형.방법 장10두건강자성가저안수궤수자표법분위대조조(n=4)화실험조(n=6).실험조가저복강주사20% PQ용액20 mL제비ALI모형;대조조급여등량생리염수.용맥박지시련속심배혈량(PiCCO2)감측의동태감측동물심솔(HR)、평균동맥압(MAP)、혈관외폐수지수(EV LWI)、폐혈관통투성지수(PVPI),기록동맥혈pH치、동맥혈양분압(PaO2)、동맥혈이양화탄분압(PaCO2)、양합지수(PaOJFiO2),이급기도봉압(PIP)、기도평태압(Pplat),매0.5 h측정1차,직도PaOJFiO2≤300 mmHg(1 mmHg=0.133 kPa).제모성공시현미경하관찰폐조직병이학개변.결과 실험조5두저성공건립ALI모형,평균제모성공시간위(4.5±0.2)h.실험조염독후HR、MAP、EVLWI、PVPI、PIP화Pplat균정상승추세,제모성공시각지표명현고우대조조[HR(차/min):132.0±6.9비113.0±3.4,t=-21.632,P=0.000; MAP(mmHg):114.0±6.0비98.0±3.5,t=-18.217,P=0.000; EVLWI(mUkg):19.2±2.8비12.5±1.2,t=-76.283,P=0.000; PVPI:5.9±1.3비3.1±0.4,t=-31.879,P=0.000; PIP(cmH2O,1 cmH2O=0.098 kPa):25.4±2.5비18.6±1.5,t=-77.421,P=0.000;Pplat(cmH2O):19.6±2.2비13.5±1.7,t=-69.452,P=0.000].실험조염독후pH치、PaO2급PaO2/FiO2균정하강추세,이PaCO2축점상승,제모성공시혈기분석지표여대조조비교차이균유통계학의의[pH치:7.35±0.04비7.43±0.05,t=9.108,P=0.000; PaO2(mmHg):82.0±7.4비172.0± 11.6,t=102.470,P=0.000; PaCO2(mmHg):44.0±4.0비35.0±2.0,t=-10.217,P=0.000; PaOjFiO2(mmHg):273.0±14.8비573.0±22.5,t=341.565,P=0.000].폐조직병리결과현시,제모성공시폐조직출현명현적손상성개변.결론 채용복강주사20% PQ용액20 mL가이건립은정적PQ치저ALI모형.
Objective To reproduce acute lung injury (ALI) model induced by paraquat (PQ) in piglet.Methods Ten healthy female piglets were divided into control group (n =4) and the experimental group (n =6) in accordance with the random number table.The experimental group was given intraperitoneal injection of 20% PQ (20 mL) to reproduce the model of ALI,while the control group was given the same amount of normal saline.All piglets were dynamically monitored with pulse-indicated continuous cardiac output (PiCCO) for heart rate (HR),mean arterial pressure (MAP),extravascular lung water index (EVLWI) and pulmonary vascular permeability index (PVPI).Changes in arterial blood pH,oxygen partial pressure (PaO2),partial pressure of carbon dioxide (PaCO2),oxygenation index (PaOJFiO2),peak inspiratory pressure (PIP) and platform of the airway pressure (Pplat) were recorded until the PaO2/FiO2 ≤ 300 mmHg (1 mmHg=0.133 kPa).Pathological changes in lung tissue under microscopy were observed.Results Model of ALI induced by PQ was successfully reproduced in the experimental group in 5 piglets.The average time of successful reproduction was (4.5 ±0.2) hours.The HR,MAP,EVLWI,PVPI,PIP and Pplat of the experimental group were increased gradually after PQ intraperitoneal injection,and all indices were significantly higher than those in control group when the model was successfully reproduced [HR (bpm):132.0 ± 6.9 vs.113.0 ± 3.4,t=-21.632,P=0.000; MAP (mmHg):114.0 ± 6.0 vs.98.0 ± 3.5,t=-18.217,P=0.000; EVLWI (mL/kg):19.2 ± 2.8 vs.12.5 ± 1.2,t=-76.283,P=0.000; PVPI:5.9 ± 1.3 vs.3.1 ±0.4,t=-31.879,P=0.000; PIP (cmH2O,1 cmH2O =0.098 kPa):25.4 ± 2.5 vs.18.6 ± 1.5,t=-77.421,P=0.000 ; Pplat (cmH2O):19.6 ± 2.2 vs.13.5 ± 1.7,t=-69.452,P=0.000].The pH value,PaO2 and PaO2/FiO2 declined gradually while the PaCO2 elevated gradually in experimental group after PQ intraperitoneal injection,the differences between the two groups were statistically significant [pH value:7.35 ±0.04 vs.7.43 ±0.05,t=9.108,P=0.000; PaO2 (mmHg):82.0 ±7.4 vs.172.0 ± 11.6,t=102.470,P=0.000; PaCO2 (mmHg):44.0±4.0 vs.35.0 ±2.0,t=-10.217,P=0.000; PaO2/FiO2 (mmHg):273.0 ± 14.8 vs.573.0 ± 22.5,t=341.565,P=0.000].Obvious damage of pulmonary tissue was shown when the model was reproduced.Conclusion By intraperitoneal injections of 20% PQ 20 mL,a stable PQ-induced ALI model can be reproduced in piglets.