通气侧肺吸入伊洛前列素对肺动脉压和缺氧性肺血管收缩的影响

发布时间：2018-06-30 02:53

  本文选题：单肺通气 + 原位离体肺灌注　； 参考：《临床麻醉学杂志》2017年02期

【摘要】：目的 探讨雾化吸入伊洛前列素对大鼠单肺通气(one-lung ventilation,OLV)期间肺动脉压和缺氧性肺血管收缩(hypoxic pulmonary vasoconstriction,HPV)的影响。方法 雄性SD大鼠30只,随机分为A、B、C三组,每组10只。原位离体肺灌注模型建立后,调整气管导管深度致左侧肺OLV,FiO_2为100%,打开连接于呼吸回路的雾化器,A组吸入生理盐水,B组吸入伊洛前列素0.05μg·kg-1·min-1,C组吸入伊洛前列素0.1μg·kg~(-1)·min~(-1),记录灌注10min(T_1)、雾化吸入10min(T_2)和OLV 1h(T_3)的平均肺动脉压(MPAP)及左心房引流液氧分压(PaO_2)。通过测量T_1、T_2和T_3时的左心房引流液PaO_2计算氧合指数(oxygenation index,OI)。实验结束分别取双侧肺组织进行电镜检查。结果 与T_1时比较,T_2、T_3时三组MPAP明显升高(P0.05);T_2、T_3时B、C组MPAP明显低于A组(P0.05),且C组MPAP明显低于B组(P0.05)。与T_1时比较,T_2、T_3时三组OI明显降低(P0.05);T_2、T_3时C组OI明显高于B组(P0.05)。相对于B、C组通气侧,A组通气侧与A、B、C组非通气侧Ⅱ型肺泡上皮细胞核膜外突内陷,部分板层小体排空。结论 在大鼠原位肺灌注模型中,单肺通气期间雾化吸入伊洛前列素能明显降低平均肺动脉压,减少肺内分流并增加氧合。
[Abstract]:Objective to investigate the effects of aerosol inhalation of iloprost on pulmonary artery pressure and hypoxic pulmonary vasoconstriction during one-lung ventilation in rats. Methods Thirty male Sprague-Dawley rats were randomly divided into three groups, 10 rats in each group. After the establishment of in situ isolated lung perfusion model, Adjusting the depth of trachea catheter to induce left lung OLVFiO2 is 100g. The nebulizer attached to the respiratory loop is opened. Group A inhales iloprostatin (0. 5 渭 g kg-1 min-1) in group B and group C inhales iloprostatin (0. 1 渭 g kg-1). The perfusion of 10min (T1), nebulized inhalation of 10min (T2) and OLV1 h (T3) are recorded. Mean pulmonary artery pressure (MPAP) and partial pressure of oxygen in left atrial drainage fluid (PaO2). The oxygenation index (oxygenation index) was calculated by measuring the left atrial drainage fluid Pao _ 2 of T _ 1 / T _ 2 and T _ 3. At the end of the experiment, bilateral lung tissues were examined by electron microscopy. Results compared with T1, MPAP in the three groups was significantly higher (P0.05) than that in group A (P0.05), and MPAP in group C was significantly lower than that in group A (P0.05), and MPAP in group C was significantly lower than that in group B (P0.05). Compared with T1, the OI of group C was significantly higher than that of group B at the time of T _ 2 / T _ 3 (P0.05). Compared with the ventilation side of group A and group A, the nuclear extracellular process of type 鈪，

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