山东医药
山東醫藥
산동의약
SHANDONG MEDICAL JOURNAL
2014年
14期
1-4
,共4页
李毅%段蕴铀%韩志海%刘于红
李毅%段蘊鈾%韓誌海%劉于紅
리의%단온유%한지해%류우홍
急性肺损伤%海水浸泡%肺泡表面活性蛋白A%肺泡表面活性蛋白B%地塞米松
急性肺損傷%海水浸泡%肺泡錶麵活性蛋白A%肺泡錶麵活性蛋白B%地塞米鬆
급성폐손상%해수침포%폐포표면활성단백A%폐포표면활성단백B%지새미송
acute lung injury%seawater immersion%alveolar surfactant protein-A%alveolar surfactant protein-B%dex-amethasone
目的：探讨地塞米松对海水浸泡胸部开放伤所致致急性肺损伤（ ALI）的治疗作用及其机制。方法取健康成年杂交犬16只制备海水浸泡胸部开放伤ALI模型，随机分为对照组及治疗组各8只。治疗组于海水浸泡30 min后静脉注射地塞米松1 mg/kg，对照组静脉注射等量生理盐水。动态观察伤后动脉血气指标（ PaO2、PaO2/FiO2），支气管肺泡灌洗液（ BALF）、血清中体内肺表面活性蛋白A和B（ SP-A、SP-B）含量变化及血管外肺水含量指数（ EVL-WI）、肺微血管通透性（ ELI ）变化。结果伤后4 h治疗组PaO2、PaO2/FiO2显著高于对照组（ P均＜0．05），EVL-WI、ELI均低于对照组（P均＜0．05），SP-A、SP-B含量在BALF中高于对照组而在血清中低于对照组（ P均＜0．05）。结论地塞米松能改善胸部开放伤后海水浸泡致ALI犬的缺氧及减轻肺水肿，其机制可能为提高肺内SP-A、SP-B含量。
目的：探討地塞米鬆對海水浸泡胸部開放傷所緻緻急性肺損傷（ ALI）的治療作用及其機製。方法取健康成年雜交犬16隻製備海水浸泡胸部開放傷ALI模型，隨機分為對照組及治療組各8隻。治療組于海水浸泡30 min後靜脈註射地塞米鬆1 mg/kg，對照組靜脈註射等量生理鹽水。動態觀察傷後動脈血氣指標（ PaO2、PaO2/FiO2），支氣管肺泡灌洗液（ BALF）、血清中體內肺錶麵活性蛋白A和B（ SP-A、SP-B）含量變化及血管外肺水含量指數（ EVL-WI）、肺微血管通透性（ ELI ）變化。結果傷後4 h治療組PaO2、PaO2/FiO2顯著高于對照組（ P均＜0．05），EVL-WI、ELI均低于對照組（P均＜0．05），SP-A、SP-B含量在BALF中高于對照組而在血清中低于對照組（ P均＜0．05）。結論地塞米鬆能改善胸部開放傷後海水浸泡緻ALI犬的缺氧及減輕肺水腫，其機製可能為提高肺內SP-A、SP-B含量。
목적：탐토지새미송대해수침포흉부개방상소치치급성폐손상（ ALI）적치료작용급기궤제。방법취건강성년잡교견16지제비해수침포흉부개방상ALI모형，수궤분위대조조급치료조각8지。치료조우해수침포30 min후정맥주사지새미송1 mg/kg，대조조정맥주사등량생리염수。동태관찰상후동맥혈기지표（ PaO2、PaO2/FiO2），지기관폐포관세액（ BALF）、혈청중체내폐표면활성단백A화B（ SP-A、SP-B）함량변화급혈관외폐수함량지수（ EVL-WI）、폐미혈관통투성（ ELI ）변화。결과상후4 h치료조PaO2、PaO2/FiO2현저고우대조조（ P균＜0．05），EVL-WI、ELI균저우대조조（P균＜0．05），SP-A、SP-B함량재BALF중고우대조조이재혈청중저우대조조（ P균＜0．05）。결론지새미송능개선흉부개방상후해수침포치ALI견적결양급감경폐수종，기궤제가능위제고폐내SP-A、SP-B함량。
Objective To investigate the effect of dexamethasone for acute lung injury ( ALI ) following open chest trauma and sea water immersion in dogs and its mechanism .Methods Sixteen healthy adult dogs were used to make the ALI models by seawater immersed thoracic cavity after open chest trauma .Then the ALI models were randomly assigned in-to the control group ( CG) and the dexamethasone treatment group ( DG) , 8 in each group .Dogs in the DG group were in-travenously injected with 1 mg/kg dexamethasone ( DG) 30 min after open chest trauma and sea water immersion , and dogs in the CG group were treated with equal normal saline .Arterial blood gas indexes (PaO2 and PaO2/FiO2) and expression changes of alveolar surfactant protein-A ( SP-A) and alveolar surfactant protein-B ( SP-B) in the lung bronchoalveolar lav-age fluid ( BALF) and serum as well as the EVL-WI and ELI were observed .Results At 4 h after treatment , the PaO2 and PaO2/FiO2 in the DG group was significantly higher than that of the control group (P<0.05), the EVL-WI and ELI in the DG group was lower than that of the control group (P<0.05), and the SP-A and SP-B in the DG group in the BALF was higher than that of the CG group but lower than in the blood serum .Conclusion Dexamethasone can relieve hypoxia and pulmonary edema after open chest trauma and sea water immersion in dogs and its mechanism may be associated with the increase of the SP-A and SP-B contents in lungs .
