摘要
目的探讨不同潮气量机械通气在大鼠急性肺损伤发生中的作用。方法32只Wistar大鼠随机分为对照组、小潮气量组、常规潮气量组和大潮气量组。分别在肉眼、光镜和电镜下观察各组大鼠肺组织病理学改变,测定动脉血气和BALF中性粒细胞计数(PMN)、蛋白含量和髓过氧化物酶(MPO)活性。结果小潮气量组肺组织在肉眼、光镜和电镜下观察与对照组比较差异无显著性；常规潮气量和大潮气量组肺组织在光镜和电镜下可观察到具有不同程度损伤改变,其BALF中PMN、MPO活性和蛋白含量均明显高于对照组和小潮气量组,而动脉血氧分压(PaO_2)明显低于对照组和小潮气量组(P＜0．01,P＜0．05)；大潮气量组BALF中MPO活性和蛋白含量与常规潮气量组比较差异也有显著性(P＜0．01)；小潮气量组各项指标与对照组比较差异均无统计学意义(P＞0．05)。结论小潮气量通气对正常肺组织无明显影响,但没有任何肺保护措施的常规潮气量通气对正常肺组织具有一定损伤作用,其损伤作用与中性粒细胞在肺内募集和活化有密切关系。
Objective To investigate the effects of different tidal volume ventilation on acute lung injury in rats. Methods Thirty-two normal Wistar rats were randomly divided into four groups： control group, low tidal volume group （L-VT）, conventional tidal volume group （C-VT） and high tidal volume group （H-VT）. The pathologic changes of the lungs were observed under macrography, light and electron microscope. The blood gas analysis （PaO2）, the counts of neutrophils （PMN）, the levels of protein and the myloperexidase （MPO） activities in bronchoalveular lavage fluid （BALF） were measured by biochemical methods respectively. Results There were no distinct pathological differences between L-VT group and control group under macrography, light and electron microscope. In the C-VT and H-VT groups, there were different degree of lung injuries under light and electron microscope, their PMN, MPO activity and protein level in BALF were significantly higher than those of control and L-VT goups and their PaO2 were significantly lower than those of control and L- VT groups （P〈0.01, P〈 0.05） . The MPO activity and the protein level in BALF were also significantly higher than those of C-VT group （P 〈 0.01） Of the above indexes, there were no statistical differences between L-VT group and control group （ P 〉 0.05）. Condition Conventional tidal volume ventilation alone, without any lung-protective strategy, could produce injuries to the normal lung tissues, while low tidal volume ventilation hadn＇t effects on them. The injury effects produced by mechanical ventilation was closely related to the recruitment and activation of neutrophils in the lung.
出处
《中华急诊医学杂志》
CAS
CSCD
2006年第7期608-611,共4页
Chinese Journal of Emergency Medicine
基金
山西省自然科学基金(20041112)
关键词
机械通气
急性肺损伤
髓过氧化物酶
支气管肺泡灌洗液
Mechanical ventilation
Acute lung injury
Myloperoxidase
Bronchoalveolar lavage fluid
