不同剂量全氟化碳汽化吸入预处理治疗急性肺损伤兔的实验研究
불동제량전불화탄기화흡입예처리치료급성폐손상토적실험연구
The experimental study of three different doses of vaporized perfluorocarbon inhalation pretreatment on rabbits in acute lung injury
  • 万方数据
    国际麻醉学与复苏杂志 국제마취학여복소잡지
    INTERNATIONAL JOURNAL OF ANESTHESIOLOGY AND RESUSCITATION
    2013年 9期 775-778 ,共4页

    温晓晖%郑曦%余革%赵子良

    온효휘%정희%여혁%조자량

    全氟化碳%预处理%急性肺损伤%早期炎性因子 全氟化碳%預處理%急性肺損傷%早期炎性因子
    전불화탄%예처리%급성폐손상%조기염성인자
    Perfluorocarbon%Pretreatment%Acute lung injury%Inflammatory factors
    目的 探讨不同剂量全氟化碳(perfluorocarbon,PFC)汽化吸入预处理对油酸型急性肺损伤(acute lung injury,ALI)实验兔早期炎性因子的影响,并得到其中最低有效预处理剂量. 方法 将24只实验兔采用随机数字表法,分为4组(每组6只),对照组(C组)、PFC 1 ml·kg-1·h-1预处理组(PFC-1组)、PFC 2ml·kg-1·h-1预处理组(PFC-2组)、PFC 3 ml· kg-1·h-1预处理组(PFC-3组).动物麻醉后气管插管行机械通气,C组机械通气60 min后建立油酸型ALI模型,3组预处理组分别汽化吸入1 ml·kg-1·h-1、2ml·kg-1·h4和3ml·kg1·h-1速率的PFC 60 min,再建立油酸型ALI模型,4组在ALI后继续行机械通气120 min.4组分别于麻醉通气30 min(T1,基础值)、PFC预处理60 min时(T2,C组为机械通气60 min)、ALI造模成功时(T3)、ALI后120 min(T4)等时点检测氧合指数(PaO2/FiO2).实验结束后留静脉血离心取血清,对左肺进行肺灌洗留取肺泡灌洗液(bronchoalveolar lavage fluid,BALF),通过ELISA法检测血清及BALF中肿瘤坏死因子-α(tumor necrosis factor-α,TNF-α)和白介素-1β (interleckin-1β,IL-1β)的含量. 结果 与C组(477±5、472±5、103±5、69±4)比较,3组PFC预处理组[PFC-1(474±11、478±4、122±12、83±5)、PFC-2组(472±10、478±4、140±11、88±3)、PFC-3组(479±9、480±6、146±15、86±2)]在各时点PaO2/FiO2均明显升高(P＜0.05),其中PFC-2组、PFC-3组PaO2/FiO2均高于同时点的PFC-1组(P＜0.05).与C组(229±5) ng/L比较,PFC-1组(220±5) ng/L、PFC-2组(209±3) ng/L和PFC-3组(212±3) ng/L组血清中TNF-α的含量明显降低(P＜0.05),其中PFC-2组、PFC-3组较PFC-1组显著降低(P＜0.05);PFC-2组(323±9) ng/L、PFC-3组(344±12) ng/L BALF中TNF-α的含量均较C组(365±14) ng/L和PFC-1组(367±13) ng/L明显降低(P＜0.05),其中PFC-2组比PFC-3组明显降低(P＜0.05).血清[C组(102±3) ng/L、PFC-1组(100±3)ng/L、PFC-2组(77±1) ng/L、PFC-3组(84±2) ng/L]和BALF[C组(116±2) ng/L、PFC-1组(116±3) ng/L、PFC-2组(93±2) ng/L、PFC-3组(96±4) ng/L]中IL-1β的含量,PFC-2、PFC-3组均较C组和PFC-1组明显降低(P＜0.05),其中血清中PFC-2组比PFC-3组明显降低(P＜0.05). 结论 经气道2 ml·kg-1·h-1和3 ml· kg-1·h-1的PFC吸入两种速率的预处理后,都能改善ALI兔的氧合功能,减少早期炎性因子TNF-α和IL-1β的释放,考虑2ml· kg-1·h-1为3组PFC吸入预处理中最低有效剂量.
    목적 탐토불동제량전불화탄(perfluorocarbon,PFC)기화흡입예처리대유산형급성폐손상(acute lung injury,ALI)실험토조기염성인자적영향,병득도기중최저유효예처리제량. 방법 장24지실험토채용수궤수자표법,분위4조(매조6지),대조조(C조)、PFC 1 ml·kg-1·h-1예처리조(PFC-1조)、PFC 2ml·kg-1·h-1예처리조(PFC-2조)、PFC 3 ml· kg-1·h-1예처리조(PFC-3조).동물마취후기관삽관행궤계통기,C조궤계통기60 min후건립유산형ALI모형,3조예처리조분별기화흡입1 ml·kg-1·h-1、2ml·kg-1·h4화3ml·kg1·h-1속솔적PFC 60 min,재건립유산형ALI모형,4조재ALI후계속행궤계통기120 min.4조분별우마취통기30 min(T1,기출치)、PFC예처리60 min시(T2,C조위궤계통기60 min)、ALI조모성공시(T3)、ALI후120 min(T4)등시점검측양합지수(PaO2/FiO2).실험결속후류정맥혈리심취혈청,대좌폐진행폐관세류취폐포관세액(bronchoalveolar lavage fluid,BALF),통과ELISA법검측혈청급BALF중종류배사인자-α(tumor necrosis factor-α,TNF-α)화백개소-1β (interleckin-1β,IL-1β)적함량. 결과 여C조(477±5、472±5、103±5、69±4)비교,3조PFC예처리조[PFC-1(474±11、478±4、122±12、83±5)、PFC-2조(472±10、478±4、140±11、88±3)、PFC-3조(479±9、480±6、146±15、86±2)]재각시점PaO2/FiO2균명현승고(P＜0.05),기중PFC-2조、PFC-3조PaO2/FiO2균고우동시점적PFC-1조(P＜0.05).여C조(229±5) ng/L비교,PFC-1조(220±5) ng/L、PFC-2조(209±3) ng/L화PFC-3조(212±3) ng/L조혈청중TNF-α적함량명현강저(P＜0.05),기중PFC-2조、PFC-3조교PFC-1조현저강저(P＜0.05);PFC-2조(323±9) ng/L、PFC-3조(344±12) ng/L BALF중TNF-α적함량균교C조(365±14) ng/L화PFC-1조(367±13) ng/L명현강저(P＜0.05),기중PFC-2조비PFC-3조명현강저(P＜0.05).혈청[C조(102±3) ng/L、PFC-1조(100±3)ng/L、PFC-2조(77±1) ng/L、PFC-3조(84±2) ng/L]화BALF[C조(116±2) ng/L、PFC-1조(116±3) ng/L、PFC-2조(93±2) ng/L、PFC-3조(96±4) ng/L]중IL-1β적함량,PFC-2、PFC-3조균교C조화PFC-1조명현강저(P＜0.05),기중혈청중PFC-2조비PFC-3조명현강저(P＜0.05). 결론 경기도2 ml·kg-1·h-1화3 ml· kg-1·h-1적PFC흡입량충속솔적예처리후,도능개선ALI토적양합공능,감소조기염성인자TNF-α화IL-1β적석방,고필2ml· kg-1·h-1위3조PFC흡입예처리중최저유효제량.
    Objective To assess the intervention effects of different doses vaporized perfluorocarbon (PFC) inhalation pretreatment in rabbits with oleic acid induced acute lung injury (ALI),and to obtain the minimum effective pretreatment dose.Methods Twenty-four New Zealand rabbits were randomly divided into 4 groups (n=6):normal control group (group C),PFC pretreatment by 1 ml·kg-1·h-1 group (PFC-1),PFC pretreatment by 2 ml·kg-1·h-1 group (PFC-2) and PFC pretreatment by 3 ml·kg-1·h-1group(PFC-3).All rabbits were anesthetized and mechanically ventilated by tracheal intubation.Group C was induced ALI by oleic acid after mechanically ventilated for 60 min.Three PFC pretreatment groups were vaporized inhalation PFC separately by 1 ml· kg-1· h-1,2 ml ·kg-1 ·h-1 and 3 ml·kg-1 ·h-1 for 60 min before ALI induced.After then four groups were mechanically ventilated for 120 min.Oxygenation indexes (PaO2/FiO2) were measured at baseline,when the PFC pretreatment finished (group C were measured when mechanically ventilated for 60 min),when ALI was just established,and 120 min after ALI.After above operations,samples of the blood serum were obtained by centrifugation of the venous blood,and lung lavage fluid was obtained by lavaging the left lung.The concentrations of TNF-α and IL-1β in blood serum and lung lavage fluid were detected by ELISA.Results Compare to group C [(477±5),(472±5),(103±5),(69±4)],PaO2/FiO2 in three PFC[PFC-1 (474±11,478±4,122±12,83±5),PFC-2 (472±10,478±4,140±11,88±3),PFC-3(479±9,480±6,146±15,86±2)] were significantly increased (P＜0.05).Among the PFC pretreatment g roups,PaO2/FiO2 raised significantly both in PFC-2 and PFC-3 when compared with PFC-1 (P＜0.05).Compare to group C (229±5)ng/L,the concentrations of TNF-α in three PFC [PFC-1 (220±5) ng/L,PFC-2 (209±3) ng/L,PFC-3 (212±3) ng/L] were significantly reduced (P＜0.05) in blood serum,and it decreased significantly in PFC-2 and PFC-3 when compared with PFC-1 (P＜0.05).In lung lavage fluid,The concentrations of TNF-α in PFC-2 (323±9) ng/L and PFC-3(344±12) ng/L were both significantly lower than that in group C(365±14) ng/L and PFC-1 (367±13) ng/L(P＜0.05),and it is significantly decreased in PFC-2 when compared with PFC-3(P＜0.05).The concentrations of IL-1β in blood serum [group C (102±3) ng/L,PFC-1(100±3) ng/L,PFC-2(77±1) ng/L,PFC-3(84±2) ng/L] and lung lavage fluid[group C(116±2) ng/L,PFC-1(116±3) ng/L,PFC-2(93±2) ng/L,PFC-3(96±4) ng/L] were both significantly lower than that in group C and PFC-1 (P＜0.05),there is significantly reduced in PFC-2 when compared with PFC-3in blood serum(P＜0.05).Conclusions After vaporized PFC inhalation pretreatment by 2 ml·kg-1·h-1 and 3 ml·kg-1·h-1 can improve oxygenation and decrease the release of TNF-α and IL-1β in rabbits with OA-induced ALI,but there is no dose-depedent effect difference between the two groups,so the minimum effective pretreatment dose is 2 ml·kg-1·h-1 in three PFC pretreatment groups.
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