• 第三軍醫(yī)大學(xué)新橋醫(yī)院全軍呼吸內(nèi)科研究所(重慶 400037);

目的 觀察霧化吸入全氟化碳(PFC)對急性肺損傷(ALI)兔肺組織病理學(xué)變化、氣體交換及腫瘤壞死因子-α(TNF-α) mRNA表達(dá)的影響。方法 用油酸制備兔ALI模型后,隨機(jī)分為常規(guī)機(jī)械通氣(CMV)組和PFC組,每組8只動物。分別在ALI前,ALI后,以及治療后1,2,3和4 h共6個時相點觀察動脈血氣指標(biāo)的變化,實驗結(jié)束后取6個不同部位的肺組織做病理切片,取2個不同部位的肺組織做TNF-α mRNA原位雜交。結(jié)果 PFC組PaO2及肺靜態(tài)順應(yīng)性(CLst)顯著高于CMV組;PFC組病理改變輕于CMV組。原位雜交提示PFC組TNF-α mRNA原位表達(dá)低于CMV組。自身比較發(fā)現(xiàn),背側(cè)肺葉TNF-α mRNA表達(dá)重于腹側(cè)肺葉(P lt;0.05)。結(jié)論 霧化吸入PFC能明顯改善實驗兔ALI肺氧合能力,升高PaO2,改善CLst,減少肺組織中的TNF-α mRNA表達(dá)。

引用本文: 黃志堅,李琦,王長征,錢桂生,宋鵬. 全氟化碳霧化吸入對兔急性肺損傷肺組織結(jié)構(gòu)及抗炎作用的影響. 中國呼吸與危重監(jiān)護(hù)雜志, 2007, 6(1): 45-48. doi: 復(fù)制

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3. Bleyl JU,Ragaller M,Tscho U,et al.Vaporized perfluorocarbon improves oxygenation and pulmonary function in an ovine model of acute respiratory distress syndrome.Anesthesiology,1999,91:461-469.
4. Kelly KP,Stenson BJ,Drummond GB.Randomised comparison of partial liquid ventilation,nebulised perfluorocarbon,porcine surfactant,artificial surfactant,and combined treatments on oxygenation,lung mechanics,and survival in rabbits after saline lung lavage.Intensive Care Med,2000,26:1523-1530.
5. Kandler MA,von der Hardt K,Schoof E,et al.Persistent improvement of gas exchange and lung mechanics by aerosolized perfluorocarbon.Am J Respir Crit Care Med,2001,164:31-35.
6. 王曉光,劉又寧.全氟化碳治療急性肺損傷/急性呼吸窘迫綜合征的新進(jìn)展.國外醫(yī)學(xué)呼吸系統(tǒng)分冊,2005,25:517-519.
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8. Noble WH,Severinghaus JW.Thermal and conductivity dilution curves for rapid quantitation of pulmonary edema.J Appl Physiol,1972,32:770-775.
9. 錢桂生.在實踐中提高對急性肺損傷和急性呼吸窘迫綜合征新概念的認(rèn)識.中國呼吸與危重監(jiān)護(hù)雜志,2002,1:199-201.
10. von der Hardt K,Kandler MA,F(xiàn)ink L,et al.Laser-assisted microdissection and real-time PCR detect anti-inflammatory effect of perfluorocarbon.Am J Physiol Lung Cell Mol Physiol,2003,285:L55-L62.
11. Quintel M,Heine M,Hirschl RB,et al.Effects of partial liquid ventilation on lung injury in a model of acute respiratory failure:a histologic and morphometric analysis.Crit Care Med,1998,26:833-843.
12. 朱光發(fā),張國清,郭海英,等.肺表面活性物質(zhì)對急性呼吸窘迫綜合征肺內(nèi)炎癥反應(yīng)的影響.中國呼吸與危重監(jiān)護(hù)雜志,2002,1:206-209.
13. 樊毫軍,張健鵬,劉又寧.吸入全氟化碳治療急性肺損傷研究進(jìn)展.中國呼吸與危重監(jiān)護(hù)雜志,2006,5:63-65.
14. Brower RG,Ware LB,Berthiaume Y,et al.Treatment of ARDS.Chest,2001,120:1347-1367.
15. 彭雪梅,孫嬋,王華東.部分液體通氣對急性肺損傷小豬肺組織結(jié)構(gòu)及氣體交換的影響.中國病理生理雜志,2005,21:129-133.
  1. 1. Leach CL,Greenspan JS,Rubenstein SD,et al.Partial liquid ventilation with perflubron in premature infants with severe respiratory distress syndrome.N Engl J Med,1996,335:761-767.
  2. 2. Ragaller M,Bleyl J,Tscho U,et al.Effects of inhalation of perfluorocarbon aerosol on oxygenation and pulmonary function compared to PGI2 inhalation in a sheep model of oleic acid-induced lung injury.Intensive Care Med,2001,27:889-897.
  3. 3. Bleyl JU,Ragaller M,Tscho U,et al.Vaporized perfluorocarbon improves oxygenation and pulmonary function in an ovine model of acute respiratory distress syndrome.Anesthesiology,1999,91:461-469.
  4. 4. Kelly KP,Stenson BJ,Drummond GB.Randomised comparison of partial liquid ventilation,nebulised perfluorocarbon,porcine surfactant,artificial surfactant,and combined treatments on oxygenation,lung mechanics,and survival in rabbits after saline lung lavage.Intensive Care Med,2000,26:1523-1530.
  5. 5. Kandler MA,von der Hardt K,Schoof E,et al.Persistent improvement of gas exchange and lung mechanics by aerosolized perfluorocarbon.Am J Respir Crit Care Med,2001,164:31-35.
  6. 6. 王曉光,劉又寧.全氟化碳治療急性肺損傷/急性呼吸窘迫綜合征的新進(jìn)展.國外醫(yī)學(xué)呼吸系統(tǒng)分冊,2005,25:517-519.
  7. 7. Nakazawa K,Yokoyama K,Matsuzawa Y,et al.Pulmonary administration of prostacyclin (PGI2) during partial liquid ventilation in an oleic acid-induced lung injury:inhalation of aerosol or intratracheal instillation? Intensive Care Med,2001,27:243-250.
  8. 8. Noble WH,Severinghaus JW.Thermal and conductivity dilution curves for rapid quantitation of pulmonary edema.J Appl Physiol,1972,32:770-775.
  9. 9. 錢桂生.在實踐中提高對急性肺損傷和急性呼吸窘迫綜合征新概念的認(rèn)識.中國呼吸與危重監(jiān)護(hù)雜志,2002,1:199-201.
  10. 10. von der Hardt K,Kandler MA,F(xiàn)ink L,et al.Laser-assisted microdissection and real-time PCR detect anti-inflammatory effect of perfluorocarbon.Am J Physiol Lung Cell Mol Physiol,2003,285:L55-L62.
  11. 11. Quintel M,Heine M,Hirschl RB,et al.Effects of partial liquid ventilation on lung injury in a model of acute respiratory failure:a histologic and morphometric analysis.Crit Care Med,1998,26:833-843.
  12. 12. 朱光發(fā),張國清,郭海英,等.肺表面活性物質(zhì)對急性呼吸窘迫綜合征肺內(nèi)炎癥反應(yīng)的影響.中國呼吸與危重監(jiān)護(hù)雜志,2002,1:206-209.
  13. 13. 樊毫軍,張健鵬,劉又寧.吸入全氟化碳治療急性肺損傷研究進(jìn)展.中國呼吸與危重監(jiān)護(hù)雜志,2006,5:63-65.
  14. 14. Brower RG,Ware LB,Berthiaume Y,et al.Treatment of ARDS.Chest,2001,120:1347-1367.
  15. 15. 彭雪梅,孫嬋,王華東.部分液體通氣對急性肺損傷小豬肺組織結(jié)構(gòu)及氣體交換的影響.中國病理生理雜志,2005,21:129-133.