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| 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 |
| Effect of aerosolized iloprost inhalation on pulmonary arterial pressure and hypoxic pulmonary vasoconstriction during one-lung ventilation |
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| DOI： |
| 中文关键词: 单肺通气 原位离体肺灌注 伊洛前列素 肺动脉压 缺氧性肺血管收缩 |
| 英文关键词: One-lung ventilation Models of lung perfusion Iloprost Pulmonary arterial pressure Hypoxic pulmonary vasoconstriction |
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| 中文摘要: |
| 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，FiO2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0.05 μg·kg-1·min-1，C组吸入伊洛前列素0.1 μg·kg-1·min-1，记录灌注10 min（T1）、雾化吸入10 min（T2）和OLV 1 h（T3）的平均肺动脉压（MPAP）及左心房引流液氧分压（PaO2）。通过测量T1、T2和T3时的左心房引流液PaO2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T1时比较，T2、T3时三组MPAP明显升高（P<0.05）；T2、T3时B、C组MPAP明显低于A组（P<0.05），且C组MPAP明显低于B组（P<0.05）。与T1时比较，T2、T3时三组OI明显降低（P<0.05）；T2、T3时C组OI明显高于B组（P<0.05）。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。 |
| 英文摘要: |
| Objective To investigate the effect of aerosol inhalation of iloprost on pulmonary arterial pressure and hypoxic pulmonary vasoconstriction (HPV) during one-lung ventilation (OLV) in rats. Methods Thirty male rats were randomly divided into three groups, 10 in each group. Models of lung perfusion were established, 100% FiO2 was ensured under the condition of OLV and the atomizers were opened. Atomization inhalation with normal saline was performed in group A, iloprost at a concentration of 0.05 μg·kg-1·min-1 in group B and iloprost at a concentration of 0.1 μg·kg-1·min-1 in group C. Mean pulmonary artery pressure (MPAP) and PaO2 of drainage-fluid from left atrium were recorded at time points of perfusion for 10 min (T1), aerosol inhalation for 10 min (T2) and OLV for 1 h (T3). Oxygenation index (OI） was calculated with PaO2 at each time point. Both lungs were harvested for electronic microscope detection. Results MPAPs at T2 and T3 were higher in contrast with that at T1 (P<0.05). A decrease of MPAP at T2 and T3 showed in group B and C when compared with those in group A (P<0.05). Group C had lower MPAP in comparison with group B at each time point. Considering the time span, we found that OIs at T2 and T3 were lower than that at T1. In addition, OIs at T2 and T3 in group C were higher than those in group B, respectively. Under electronic microscope, nuclear membranes type Ⅱ alveolar epithelial cells of both lungs in group A and of non-ventilated lungs in group B and C bulged out or invaginated and lamellar bodies were evacuated, especially when compared to those in ventilated lungs in groups B and C. Conclusion In rat models of lung perfusion, atomization inhalation with iloprost can decreased MPAP, reduce intrapulmonary shunt and increase oxygenation. |
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