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目的 探讨肺表面活性物质 (pulmonarysurfactant,PS)对内毒素诱发大鼠急性呼吸窘迫综合征 (acuterespiratorydistresssyndrome ,ARDS)的防治作用。方法 4 8只健康雄性SD大鼠 ,手术并给予机械通气后随机分为 6组 :健康对照组 (H组 ) ,ARDS模型组 (M组 ) ,其余动物根据动脉血氧分压(PaO2 ) /FiO2 比值分 2个时期 (PaO2 /FiO2 ≤ 30 0mmHg早期 E、PaO2 /FiO2 ≤ 2 0 0mmHg晚期 L)和所给猪肺PS分 2个剂量 (5 0mg/kg、 10 0mg/kg) ,两两组合成E5 0、E10 0、L 5 0和L10 0 4组。用PS后共观察 6h。结果 M组和L 5 0组的PaO2 和静态胸肺压力 容积 (P -V)曲线肺容积均较H组明显降低 (P <0 0 1) ,L10 0组上述指标明显高于M组 (P <0 0 5 ) ,而E 5 0组和E10 0组PaO2 和P V曲线肺容积均较L10 0组进一步升高(P <0 0 5 ,P <0 0 1) ,E5 0组和E10 0组间上述指标差别不明显。支气管肺泡灌洗液 (BALF)分析示L 5 0组和L10 0组饱和卵磷脂 (DSPC) /总蛋白 (TP)、TP和最小表面张力 (STmin)均较M组改善 (P <0 0 1) ,但STmin仍高于H组 (P <0 0 1) ,E5 0组和E10 0组的BALF测值均明显优于L10 0组 (P <0 0 1) ,且STmin接近H组。结论 早期应用PS疗效明显优于晚期 ,且所需剂量较小 ,可能是防治ARDS的有效手段之一
Objective To investigate the preventive and therapeutic effects of pulmonarysurfactant (PS) on endotoxin-induced acute respiratory distress syndrome (ARDS) in rats. Methods Eight healthy male Sprague-Dawley rats were randomly divided into 6 groups: healthy control group (H group) and ARDS model group (M group), and the other animals were divided into two groups according to PaO2 / FiO2 ratio was divided into two periods (PaO2 / FiO2 ≤ 30 0mmHg early E, PaO2 / FiO2 ≤ 200mmHg late L) and the lungs were divided into two doses of PS (50mg / kg, 100mg / kg) E5 0, E10 0, L 5 0 and L10 0 4 groups were combined. Total observation with PS after 6h. Results The lung volume of PaO2 and static P-V curve of M group and L 5 0 group were significantly lower than those of H group (P <0.01), and those of L10 0 group were significantly higher than those of M group (P <0 05). However, the lung volumes of PaO2 and PV in both E5 0 and E10 0 groups were significantly higher than those in L10 0 group (P <0.05, P <0.01), and those in E5 0 and E10 0 groups The difference between the above indicators is not obvious. Bronchoalveolar lavage fluid (BALF) analysis showed that the levels of saturated phosphotidylcholine (DSPC) / total protein (TP), TP and minimum surface tension (STmin) in L50 group and L100 group were significantly improved compared with those in M group ), But STmin was still higher than that of H group (P <0.01). BALF of E5 0 group and E10 0 group were significantly better than L10 0 group (P <0.01), and STmin was close to H group. Conclusion Early application of PS is better than late, and the required dose is small, may be one of the effective means of prevention and treatment of ARDS