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目的探讨雾化吸入前列腺素E1(PGE1)对急性肺损伤(ALI)猪氧合及肺内分流的影响。方法 18头健康家猪,腹腔注射戊巴比妥钠50 mg／kg,气管内插管机械通气,持续静脉输注氯胺酮100 mg、2％普鲁卡因100 ml、氯化琥珀胆碱100 mg混合液维持麻醉。记录平均动脉压(MAP)、平均肺动脉压(MPAP)、动脉血氧分压(PaO2)、动脉血二氧化碳分压(PaCO2)、肺顺应性(Cdyn)、心排出量 (CO),计算动静脉分流值(Qs／Qt)、肺血管阻力(PVR)和体循环阻力(SVR)作基础值,经气管导管向肺内注入0．1 mol／L盐酸溶液,至PaO2<100mm Hg并持续30 min为ALI模型成功,记录上述指标。动物随机分为A、B、C三组,每组6头。A组机械通气,B组机械通气,呼气末正压(PEEP),C组机械通气 PEEP,雾化吸入PGE1。观察4 h,每1 h记录上述指标一次。结果 ALI成功后,三组MAP均降低,但组间差异无统计学意义(P>0．05);三组MPAP升高,C组与A、B组比较差异有统计学意义;C组 PaO2较A、B组升高;C组Cdyn高于A组;C组CO高于A组;三组Qs／Qt升高,C组低于A、B组;C组 PVR低于A组(P<0．05)。结论雾化吸入PGE1能降低盐酸致ALI猪的氧合,改善肺气体交换,减少肺内分流。
Objective To investigate the effects of inhaled prostaglandin E1 (PGE1) on porcine oxygenation and intrapulmonary shunt in acute lung injury (ALI). Methods 18 healthy domestic pigs were injected intraperitoneally with pentobarbital sodium 50 mg / kg and endotracheal intubation was given mechanical ventilation. Continuous intravenous infusion of ketamine 100 mg, 2% procaine 100 ml, succinylcholine chloride 100 mg Mixture to maintain anesthesia. The mean arterial pressure (MAP), mean pulmonary arterial pressure (MPAP), arterial oxygen pressure (PaO2), arterial carbon dioxide (PaCO2), lung compliance (Cdyn) and cardiac output (CO) (Qs / Qt), pulmonary vascular resistance (PVR) and systemic resistance (SVR) were used as the baseline values. 0.1 mol / L hydrochloric acid solution was infused into the lungs through the endotracheal tube to PaO2 <100 mm Hg for 30 min ALI model is successful, record the above indicators. Animals were randomly divided into A, B, C three groups, each group of six. A group of mechanical ventilation, B group mechanical ventilation, positive end expiratory pressure (PEEP), C group mechanical ventilation PEEP, aerosol inhalation of PGE1. Observed 4 h, every 1 h recorded above indicators. Results MAP was decreased in all three groups after ALI was successful, but there was no significant difference between groups (P> 0.05); MPAP increased in three groups, and there was significant difference between group C and groups A and B; PaO2 The level of Cdyn in group C was higher than that in group A; the Qs / Qt in group C was higher than that in group A and B; the PVR in group C was lower than that in group A <0.05). Conclusion Aerosol inhalation of PGE1 can reduce oxygenation induced by hydrochloric acid to ALI pigs, improve lung gas exchange and reduce pulmonary shunt.