摘要
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（acutelunginjury，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）、PFC1ml·kg^-1·h^-1预处理组（PFC-1组）、PFC2ml·kg^-1·h^-1预处理组（PFC-2组）、PFC3ml·kg^-1·h^-1预处理组（PFCd组）。动物麻醉后气管插管行机械通气，c组机械通气60rain后建立油酸型Au模型，3组预处理组分别汽化吸入1ml·kg^-1·h^-1、2ml·kg^-1·h^-1和3ml·kg^-1·h^-1速率的PFC60min，再建立油酸型ALI模型，4组在ALI后继续行机械通气120min。4组分别于麻醉通气30min（T1，基础值）、PFC预处理60min时（T2，C组为机械通气60min）、Au造模成功时（T3）、ALI后120min（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（bronchoalveolarlavagefluid，BALF），通过ELISA法检测血清及BALF中肿瘤坏死因子（tumornecrosisfactorYTNF-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）．g／L和PFC-3组（212±3）ng／L组血清中TNF啾的含量明显降低（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/LBALF中TNF-or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〈0．05o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-1p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2ml·kg^-1·h^-1和3ml·kg^-1·h^-1的PFC吸入两种速率的预处理后，都能改善Au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。
Objective To assess the intervention effects of different doses vaporized perfluorocarbon （PFC） inhalation pretreatment in rabbits with oleic acid induced acute lung injury （ALl）, 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^-1 group（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 pretreatInent groups were vaporized inhalation PFC separately by 1ml·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 ALL After above operations,samples of theblood 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 PFCIPFC-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, PaO±/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-I（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-I（P〈O.05）, there is significantly reduced in PFC-2 when compared with PFC-3 in 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-indueed ALl, 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.
出处
《国际麻醉学与复苏杂志》
CAS
2013年第9期775-778,共4页
International Journal of Anesthesiology and Resuscitation
基金
基金项目：广东社会发展领域科技计划（20118031800192）
关键词
全氟化碳
预处理
急性肺损伤
早期炎性因子
Perfluorocarbon
Pretreatment
Acute lung injury
Inflammatory factors
