摘要
目的探讨盐酸戊乙奎醚(penehyclidine hydrochloride,PHC)对油酸(oleicacid,OA)诱导犬急性肺损伤(acutelunginjury,ALI)模型在机械通气治疗过程中的影响。方法健康雄性杂交犬17只,体重12～17kg。随机分为3组:对照组(n=5)、OA组(n=6)和PHC组(n=6),采用中心静脉注入OA制备ALI动物模型,对照组不造模型。造模成功后空气中稳定90min,予以机械通气,同时PHC组予0.25mg/mLPHC,OA组和对照组予等量生理盐水,在造模开始前、模型成功、机械通气开始(0h)及之后的1～6h每小时记录心率(heartrate,HR)、平均动脉压(mean arterialpressure,MAP)、中心静脉压、平均肺动脉压(mean pulmonary arterial pressure,MPAP)、肺动脉楔压及动脉血气、心排血量(cardiacoutput,CO)、血管外肺水指数(extravascular lung water index,EVLWI)、潮气量、吸氧浓度;机械通气开始后每小时记录1次气道峰压、气道平台压、平均气道压、呼吸末正压,并计算氧合指数(oxygenation index,OI)、肺循环阻力(pulmonary vascular resistance,PVR)、全身循环阻力(systemic vascular resistance,SVR)、肺泡-动脉血氧分压差(alveolar-arterial differences forO2,AaDO2)和动态肺顺应性(dynamic lung compliance,DLC)。实验结束取肺标本计算干湿重比率(dry wet weight ratio,WDR),并进行病理评分。结果血流动力学指标检测显示,造模成功后各时间点OA组和PHC组HR、MAP、CO值均较对照组低(P<0.05);OA组、PHC组和对照组MPAP、PVR、SVR呈依次降低的趋势,但组间比较差异无统计学意义(P>0.05)。肺功能学指标检测显示造模成功后各时间点OA组和PHC组OI、EVLWI值均较对照组低(P<0.05),OA组和PHC组间比较EVLWI值在4h时差异有统计学意义(P<0.05);各组AaDO2和DLC值比较差异无统计学意义(P>0.05)。PHC组WDR较OA组更好(P>0.05)。病理评分总分、肺泡水肿、炎性浸润及肺泡过度膨胀4项,OA组背侧及腹侧面最差,PHC组较好,对照组最好(P<0.05);在上皮损伤项OA组、PHC组与对照组的背侧面呈由重至轻的趋势(P<0.05)。背侧面和腹侧面之间差异无统计学意义(P>0.05)。结论PHC对OA诱导犬ALI在机械通气过程中有一定的治疗作用。
Objective To observe whether additional penehyclidine hydrochloride（PHC） in mechanical ventilation produces therapeutic effect on oleic acid（OA） induced acute lung injury（ALI） in canine.Methods Seventeen male canines（weighing 12-17 kg） were divided into control group（n=5）, OA group（n=6） and PHC group（n=6）.ALI model was developed by central venous injection of OA in canines of OA and PHC groups.ALI model was kept steady in air, all groups received mechanical ventilation 90 minutes later.Three groups received normal saline 0.25 mg/kg without injection of OA（control group）, normal saline 0.25 mg/kg after injection of OA（OA group） and PHC 0.25 mg/kg after injection of OA（PHC group） respectively at 0 h（90 minutes after onset time of ALI/ARDS）.The heart rate（HR）, mean arteial pressure（MAP）, mean pulmonary arterial pressure（MPAP）, central venous pressure（CVP）, pulmonary artery wedge pressure（PAWP）, artery blood gas analysis, cardiac output（CO）, extravascular lung water index（EVLWI）, FiO2 and VT were observed respectively at baseline, onset time of ALI/ARDS and 0 h, then again at 1 hour intervals for 6 hours.Besides the above, airway peak pressure（Ppeak）, airway plat pressure（Pplat）, mean airway pressure（Pmean） and positve end-expriatory pressure（Peep） were also observed each hour during 1-6 hours.Oxygenation index（OI）, pulmonary vascular resistance（PVR）, systemic vascular resistance（SVR）, alveolar-arterial di erences for O2（AaDO2） and dynamic lung compliance（DLC） were calculated and pulmonary tissue was collected for histopathologic investigation and dry wet weight ratio（WDR） test.Results The functional parameters of PHCgroup were improved when compared those of OA group, but there was no sigin cant di erence;WDR of independent region of three groups were 80.42% ± 3.48%, 82.67% ± 4.01% and 82.26% ± 1.43% respectively;WDR of dependent region of three groups were 80.51% ± 3.60%, 83.71% ± 1.98% and 82.57% ± 1.08% respectively.WDR of PHC group were obviously improved when compared with those of OA group, but there was no signi cant di erence.Independent and dependent regions of PHC group were signi cantly improved when compared those of OA group in histopathologic scores, alveolar edema, in ammatory infiltration and over-distension（P 〈 0.01）.Conclusion Additional PHC in mechanical ventilation produces obvious therapeutic e ect on OA induced acute lung injury in canine.
出处
《中国修复重建外科杂志》
CAS
CSCD
北大核心
2009年第5期592-597,共6页
Chinese Journal of Reparative and Reconstructive Surgery
关键词
急性肺损伤/急性呼吸窘迫综合征
油酸
盐酸戊乙奎醚
犬
Acute lung injury/acute respiratory distress syndrome
Oleic acid
Penehyclidine hydrochloride
Canine
