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目的 研究吸入一氧化氮(NO)对牛肺泡表面活性剂(BPS)替代治疗肺灌洗大鼠时疗效的影响。方法 64只SD大鼠经气管导管反复肺灌洗至PaO2< 13.4kPa和PaCO2> 8.0kPa 后,随机分成对照组(组Ⅰ)、BPS25m g/kg 组(组Ⅱ)、BPS50m g/kg 组(组Ⅲ)、BPS100m g/kg 组(组Ⅳ),各组分a、b 两亚组,未吸NO为a,NO吸入为b。观察用药后PaO2 、PaCO2、肺压力-容量环及肺实质密度变化。结果 单用NO治疗组(组Ⅰb)在NO= 40ppm 时其PaO2 较组Ⅰa 显著升高。单用BPS治疗组(组Ⅱa、组Ⅲa、组Ⅳa)其PaO2 升幅及PaCO2 降幅均在用药后15 分钟内达高峰。BPS复合NO(组Ⅱb、组Ⅲb、组Ⅳb)后,仅组Ⅱb、组Ⅲb 的PaO2 均较单用BPS组有进一步的显著上升,但PaCO2 的下降不明显。而组Ⅳb 的PaO2 、PaCO2 均无明显变化。BPS治疗后吸入5ppm NO即能显著改善氧合,吸入NO浓度进一步升高并不能进一步改善氧合作用。BPS复合吸入NO后,肺顺应性较未吸入前有所降低,但无显著性差异。结论 吸入NO加强BPS替代治疗效果,减少BPS用量。吸入NO ?
Objective To study the effects of inhaled nitric oxide (NO) on the therapeutic effect of bovine alveolar surfactant (BPS) in lung lavage in rats. Methods Sixty-four Sprague-Dawley rats were randomly divided into control group (group Ⅰ), BPS group (25 mg / kg), BPS group (50 mg / kg) (Group Ⅲ), BPS100m g / kg group (group Ⅳ), each component a, b two subgroups, did not take NO as a, NO inhaled as b. PaO2, PaCO2, pulmonary pressure-volume ring and pulmonary parenchymal density were observed after treatment. Results Compared with group Ⅰa, the PaO2 of NO treated group (group Ⅰb) was significantly increased at NO = 40ppm. The PaO2 and PaCO2 decrease in BPS alone group (group IIa, group Ⅲa, group Ⅳa) all reached the peak within 15 minutes after treatment. After treated with BPS alone (group IIb, group Ⅲb, group Ⅳb), the PaO2 of group Ⅱb and group Ⅲb increased more than that of group BPS alone, but the decrease of PaCO2 was not obvious. However, PaO2 and PaCO2 in group Ⅳb did not change significantly. BPS inhalation of 5ppm NO can significantly improve oxygenation, inhalation of NO concentration further increased and can not further improve the oxygenation. BPS inhalation of NO, pulmonary compliance than before inhalation was reduced, but no significant difference. Conclusions Inhaled NO enhances the effectiveness of BPS replacement therapy and reduces the dosage of BPS. Inhalation of NO?