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目的 探讨血管紧张素转换酶抑制剂 (ACEI)在急性呼吸窘迫综合征 (ARDS)治疗中的具体作用。方法 将大鼠分为对照组、ARDS组和卡托普利 (Cap)组 ,后 2个组按不同取血时间再分为6个亚组 ,每组大鼠 5～ 6只。观察投用ACEI类药物Cap对油酸所致ARDS大鼠生理、生化指标及循环内皮细胞 (CEC)的影响。结果 在全身血压保持在正常水平下 ,Cap对ARDS有一定疗效。 2h时ARDS大鼠肺动脉压从 (2 3 5 0± 5 79)mmHg(1mmHg =0 133kPa)降到接近正常的 (14 4 3± 1 5 1)mmHg;反映肺毛细血管内皮损伤情况的CEC数量从 (6 88± 1 90 ) / 0 9μl减少到 (4 2 5± 0 2 0 ) /0 9μl;动脉血氧分压从 (35 0 8± 4 5 9)mmHg上升到 (70 4 8± 9 5 4 )mmHg ,同时肺湿干重等指标已接近正常 ;说明即使投用大剂量油酸亦仅能引起轻度肺损伤。结论 ACEI能降低肺动脉高压 ,阻抑ARDS的病情进展并对肺血管内皮细胞有一定保护作用
Objective To investigate the role of angiotensin converting enzyme inhibitor (ACEI) in the treatment of acute respiratory distress syndrome (ARDS). Methods The rats were divided into control group, ARDS group and cap group. The latter two groups were subdivided into 6 subgroups according to different blood sampling time, with 5 to 6 rats in each group. To observe the effects of administration of Cap ACEI on the physiological and biochemical indexes and the circulating endothelial cells (CEC) of ARDS rats induced by oleic acid. Results With systemic blood pressure maintained at normal levels, Cap had some effect on ARDS. Pulmonary arterial pressure dropped from (23 5 0 ± 5 79) mmHg (1 mmHg = 0 133 kPa) to nearly normal (14 4 3 ± 1 51) mmHg at 2 h in ARDS rats; the number of CECs reflecting pulmonary capillary endothelial injury (6 88 ± 1 90) / 0 9μl to (4 2 5 ± 0 2 0) / 0 9μl; the partial pressure of arterial oxygen increased from (35 0 8 ± 4 5 9) mmHg to (70 4 8 ± 9) 5 4) mmHg, while indicators such as lung wet and dry weight are close to normal; that even if the use of large doses of oleic acid can only cause mild lung injury. Conclusions ACEI can reduce pulmonary hypertension, arrest the progression of ARDS and protect pulmonary vascular endothelial cells