摘要
目的探讨新生兔机械通气吸入高体积分数氧（900mL/L）致肺损伤的表现及发病机制。方法将100只日龄1—5d的新生兔随机分为4组，A、B、C组行机械通气吸入高体积分数氧6h，A组高吸气峰压（HPIP=2．45kPa，）、B组中吸气峰压（MPIP=1．77kPa）、C组低吸气峰压（删P=0．98kPa），每组30只，通气时间为1、3、6h，每个时间点10只。10只未通气组为正常对照组（D组）。各时间点通气结束后处死动物，取其肺行支气管肺泡灌洗液（BALF）自细胞、中性粒细胞计数，测定左肺湿／于质量比（W／D），观察右肺组织病理学改变。采用SPSS11．0软件进行析因设计方差分析、多重比较LSD分析。结果与B、C组比较，A组BALF中WBC、中性粒细胞计数明显增高，W／D值显著升高，且随通气时间延长而增加。组织病理学显示A组较B、C组新生兔肺出血、肺大泡形成较明显。B组损伤最轻，C组肺叶内局部肺不张较明显。A组Ⅱ型上皮细胞增生向Ⅰ型细胞转化加速。C组以Ⅱ型上皮细胞肿胀、肺组织水肿为主，通气6h出现胶原纤维增生。结论高体积分数氧HPIP机械通气能明显加重新生兔肺损伤，而MPIP、LPIP通气对肺损伤影响较小。
Objective To explore the effect of hyperoxia through mechanical ventilation induced lung injury （VILI） in newborn rabbit. Methods One hundred newborn rabbits aged 1 - 5 days were randomly divided into 4 groups ： with 900 mL/L O2 and mechanical ventilation （MV）, group A received high peak inspiratory pressure（ HPIP）, group B received moderate peak inspiratory pressure（ MPIP）, group C received low peak inspiratory pressure（ LPIP）, and group D with no mechanical ventilation with room air. There were 30 rabbits in group A, B, C, 10 rabbits in D group. All rabbits were killed at 1,3,6 h after trial respectively. Wet - to - dry weight ratio （W/D） of left lung, and white blood cell （WBC）counts in broncho alveolar lavage fluid （BALF） were measured. The changes of lung histopathology were assessed by hema- toxylin - eosin（HE） staining and observed under light microscope. Results Compared with group B and C, the group A demonstrated more pulmonary hemorrhage and pulmonary bullae formation, and the WBC and neutrophils counts in BALF increased and the W/D was higher compared with group B and group C. Meanwhile, alveolar epithelial cell Ⅱ （ AEC Ⅱ ） hyperplasy transformed to AEC Ⅰ. In group C, AEC Ⅱ swelled and lung tissue edema showed obviously, after 6 hours collagen fibers hyperplasia appeared. Part pulmonary atelectasis was obvious in group C. Conclusions HPIP ventilation can increase lung injury induced by hyperoxia in newbom rabbits, but has minimal effects on MPIP and LPIP ventilation. Pulmonary histopathologic changes participate in the newbom rabbit machine ventilation induced lung injury.
出处
《实用儿科临床杂志》
CAS
CSCD
北大核心
2008年第6期466-468,共3页
Journal of Applied Clinical Pediatrics
基金
广东省科技计划项目资助(B30502)
关键词
兔
新生
高体积分数氧
机械通气
肺损伤
newborn rabbit
hyperoxia
mechanical ventilation
lung injury
