吸入一氧化氮及静注异丙酚治疗兔油酸型急性肺损伤

目的 观察吸入NO、静注异丙酚改善兔油酸型急性肺损伤(ALI) 的氧合效果。方法 用60 mg·kg^-1油酸引发兔ALI 后(0 h), 随机分组。模型组(n=5):单纯行机械通气;NO 组(n=5):持续吸入20 ppm NO;异丙酚组(n=5):静注异丙酚2 mg·kg^-1·h^-1。观察基础状态、0 h、2 h的平均动脉压(SAP)、HR、动脉血气及肺功能变化。治疗结束后摄胸片, 测定肺组织湿/干(W/D) 比值。结果 治疗2 h后与模型组相比, NO 组PaO₂>95 mmHg, (P<0.01)、PaO₂/FiO₂>300, 明显提高(P<0.05)、Qs/Qt、W/D 显著下降(P<0.05), 异丙酚组无改变。结论 急性肺损伤早期吸入NO 可以安全有效地改善肺循环, 提高氧合, 减轻肺水肿, 延缓肺损伤进程;异丙酚改善ALI 氧合效果不显著。

Nitric oxide inhalation and propofol injection in treatment of rabbits with oleic acid-induced acute lung injury

Aim To observe effects of inhalation of nitricoxide and intravenous propfol on pulmonary oxygenation and perfusion in rabbits with acute lung injury (ALI) induced by oleicacid.Methods Nineteen healthy adult rabbits were anesthetized with tracheotomy, and then vent ilated mechanically.Four animals were selected as normal control.The others were induced into ALI (0 h) by pulmonary injection of oleic acid (60 mg·kg^-1) and then randomly allocated into three groups:(1) control group (n=5, receiving ventilation only);(2) NO group (n=5, inhaling NO at 20 ppm);and (3) propofol group(n=5, receiving intravenous propofol 2 mg·kg^-1·h -1).The mean systemic arterial pressure (SAP), heart rate (HR), PaO₂, PaCO₂ and Qs/Qt were recorded in the time of baseline, 0 h and 2 h.X-rays of chests were given and wet-to-dry lung weig htratio (W/D) was determined after the treatment.Results 2 h after the administ ration, the mean PaO₂ (>95 mmHg, P<0.05) and PaO₂/FiO₂ (>300, P<0.05) were significantly improved and Qs/Qt (16%, P<0.05), W/D reduced significantly in the NO group, but not in the propofol group.Conclusion NO inhalation, used for ALI in early stage, can safely and effect ively improve pulmonary circulation, gas exchange, pulmonary oxy genat ion and perfusion, decrease pulmonary edema, and slow down the progress of lung injury.Propofol does not show any influence on oxygenation and pulmonary arterial pressure.