前体脂质体型猪肺表面活性物质对整肺灌洗兔呼吸窘迫模型治疗作.docVIP

前体脂质体型猪肺表面活性物质对整肺灌洗兔呼吸窘迫模型治疗作 　【摘要】 目的：观察前体脂质体型猪肺表面活性物质（PPPS）对整肺灌洗兔呼吸窘迫模型的治疗作用。方法：将PPPS水化后，经气管滴入治疗整肺灌洗型成年兔呼吸窘迫模型，观察兔的生命体征、血气、动态肺顺应性等指标的变化。结果：整肺灌洗后模型兔的血气pH、PaO2急剧下降，PaCO2 轻度上升，心率明显减慢而呼吸频率增加，SBP和DBP均明显下降；支气管肺泡灌洗液中PS含量明显下降；病理检查提示出现肺出血、肺不张、肺泡萎缩、透明膜形成等病变，符合Ⅰ型重症呼吸衰竭临床诊断标准。经气管滴入PPPS后，可以使RDS模型兔的各项指标（pH、PaO2、PaCO2、HR、BR、SBP、DBP）明显改善，肺部的病理改变也明显减轻。统计学分析结果提示，治疗组和对照组pH（F=4.572，P=0.046）、PaO2 (F=557.586，P=0.000)、PaCO2（F=96.798，P=0.000）、TV（F=117.851，P=0.000）、Cydn（F=276.996，P=0.000）、HR（F=34.975，P=0.000）、BR（F=28.167，P=0.000）、SBP（F=124.751，P=0.000）和DBP（F=108.672，P=0.000）比较差异均有统计学意义；在治疗组中，各个时间点的 pH、PaO2 、PaCO2、TV、Cydn、HR、BR、SBP和DBP比较差异均有统计学意义。结论：PPPS对实验性PS缺乏和肺损伤造成的呼吸窘迫有显著的治疗作用。 【关键词】 肺表面活性物质；前体脂质体；呼吸窘迫综合症 ［Abstract］Objective:To observe adult rabbits with acute respiratory distress syndrome (ARDS) treated by the proliposomes of pig pulmonary surfactant (PPPS). Methods:PPPS was instilled intratracheally. The control group was given saline only.Results:The following phenomena were observed:the Ph, PaO2 of the model rabbits descended sharply, the PaCO2 increased lightly, the HR slowed down obviously, but the BR increased, the SBP and DBP of the model rabbits descended markedly, and the PS content decreased dramatically. The pneumonic pathology changes showed pneumorrhagia, atelectasis, shrink of alveolus and pulmonary hyaline membrane. The above results indicated that it accorded with the standard of I-type of acute respiratory distress syndrome (ARDS). After the PPPS was applied to the model rabbits, each index nearly reached the normal level, and pneumonic pathology changes were also alleviated distinctly. The analytic result of statistics indicated that there was statistical significance in pH (F=4.572, P=0.046), PaO2 (F=557.586, P=0.000), PaCO2 (F=96.798, P=0.000), TV (F=117.851, P=0.000), Cydn (F=276.996, P=0.000), HR (F=34.975, P=0.000), BR (F=28.167, P=0.000), SBP (F=124.751, P=0.000), DBP (F=108.672, P=0.000) between the control group and the treated group. This shows PPPS has a