国际麻醉学与复苏杂志   2013, Issue (9): 1-1
    
全氟化碳汽化吸入预处理治疗急性肺损伤实验兔的剂量与效应关系
余革, 郑曦, 温晓晖, 赵子良1()
1.广州医学院第一附属医院
The dose-effect relationship of vaporized perfluorocarbon inhalation pretreatment on rabbits in acute lung injury
 全文:
摘要:

【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(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(n=6),对照组、PFC 1ml•kg-1•h-1预处理组(PFC-1)、PFC 2ml•kg-1•h-1预处理组(PFC-2)、PFC 3 ml•kg-1•h-1预处理组(PFC-3)。动物麻醉后气管插管行机械通气,C组机械通气60min后建立油酸型ALI模型,三组预处理组分别汽化吸入1 ml•kg-1•h-1、2 ml•kg-1•h-1和3 ml•kg-1•h-1速率的PFC 60 min,再建立油酸型ALI模型,四组在ALI后继续行机械通气120 min。四组分别于麻醉通气30 min(基础值)、PFC预处理60min时(C组为机械通气60min)、ALI造模成功时、ALI后120 min等时点检测氧合指数。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,通过ELISA法检测血清及肺泡灌洗液中肿瘤坏死因子-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,三组PFC预处理组[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)]在各时点氧合指数均明显升高(P<0.05),其中PFC-2、PFC-3组氧合指数均高于同时点的PFC-1组(P<0.05)。与C组(229±5pg/ml)相比,PFC-1(220±5 pg/ml)、PFC-2(209±3 pg/ml)和PFC-3(212±3 pg/ml)组血清中TNF-α的含量明显降低(P<0.05),其中PFC-2、PFC-3组较PFC-1组显著降低(P<0.05);PFC-2(323±9 pg/ml)、PFC-3(344±12 pg/ml)组肺泡灌洗液中TNF-α的含量均较C组(365±14 pg/ml)和PFC-1(367±13 pg/ml)组明显降低(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 pg/ml)、PFC-1(100±3 pg/ml) 、PFC-2(77±1 pg/ml)、PFC-3(84±2 pg/ml) ]和肺泡灌洗液[C组(116±2 pg/ml)、PFC-1(116±3 pg/ml)、PFC-2(93±2 pg/ml)、PFC-3(96±4 pg/ml)]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2 ml•kg-1•h-1为三组PFC吸入预处理中最低有效剂量。

关键词: 全氟化碳;预处理;急性肺损伤;早期炎性因子
Abstract:

[Abstract] Objective: To assess the intervention effects of different doses vaporized perfluorocarbon(PFC) inhalation pretreatment in rabbits with oleic acid(OA) 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 each): 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 OA 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 groups, PaO2/FiO2 raised significantly both in PFC-2 and PFC-3 when compared with PFC-1(P<0.05). Compare to group C(229±5pg/ml), the concentrations of TNF-α in three PFC [PFC-1(220±5 pg/ml), PFC-2(209±3 pg/ml), PFC-3(212±3 pg/ml)] 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 pg/ml) and PFC-3(344±12 pg/ml) were both significantly lower than that in group C(365±14 pg/ml) and PFC-1(367±13 pg/ml)(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 pg/ml), PFC-1(100±3 pg/ml), PFC-2(77±1 pg/ml), PFC-3(84±2 pg/ml)] and lung lavage fluid[group C(116±2 pg/ml), PFC-1(116±3 pg/ml), PFC-2(93±2 pg/ml), PFC-3(96±4 pg/ml)] 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-3 in blood serum(P<0.05). Conclusion: 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 2ml/kg/h in three PFC pretreatment groups.

Key words: perfluorocarbon; Pretreatment;Acute lung injury;Inflammatory factors