吸入NO复合米力农治疗内毒素滴入气管内致兔早期急性肺.docVIP

吸入NO复合米力农治疗内毒素滴入气管内致兔早期急性肺损伤 安徽医科大学附属省立医院麻醉科 谢言虎 李娟 章蔚 方才* 摘要　目的　观察吸入NO复合米力农治疗内毒素滴入气管内致兔早期急性肺损伤的疗效。　方法　采用内毒素滴入兔气管内复制ALI模型，将30只兔随机分为正常组、模型组、NO和米力农治疗组、NO复合米力农治疗组。监测MAP、PAP、PaO2、Qs/Qt，采集血标本测NO、MDA，计算肺湿/干重比及BALF细胞总数、PMN百分比、蛋白含量，观察肺组织形态学变化。结果 NO和米力农治疗组PaO2提高，肺动脉高压下降，肺分流率下降，通气功能改善；BALF中PMN减少，炎症得到一定抑制，肺损伤程度减轻。NO复合米力农组肺部通气功能改善较其他两组更加显著，BALF中PMN百分比显著下降，显微镜下肺泡扩张良好，肺泡间隔薄，只有少量炎性细胞。结论 米力农能增加内源性NO生成，有抗炎作用，具有一定的肺保护作用；NO复合米力农后，能更好的改善ALI肺部通气功能，降低肺动脉高压，具有更强的抑制炎症能力，有着更好的肺保护作用。 关键词：一氧化氮 米力农 急性肺损伤 内毒素 Inhaled nitric oxide combined with IV infused Milrinone in treatment of rabbits with lipopolysaccharide-induced acute lung injury Xie Yanhu , Li Juan, Zhang Wei, Fang Cai [Abstract] Objective To observe inhalation of NO combined with iv infusion of Milrinone whether can improve gas exchange of acute lung injury. Methods 30 rabbits were anesthetized with tracheotomy, and then ventilated mechanically. Six animal were selected as normal control. The 合肥 230001 安徽医科大学附属省立医院麻醉科 *为通信作者 other were induced into ALI by LPS, and randomly allocated into four groups: (1) LPS control group(n=6,receiving ventilation only); (2)NO group(n=6, inhaling NO at 20ppm);(3) NO+Milrinone group(n=6, inhaling NO 20ppm combine with iv infusing Milrinone at 5μg/kg.min after iv 50μg/kg); and (4)Milrinone group(n=6,continous iv infusing Milrinone at 5μg/kg.min after iv 50μg/kg). The mean systemic arterial pressure (mSAP), PaO2 and Qs/Qt were recorded in the time of baseline ,LPS0min ,120min, 150min. Wet-to-dry weight ratio(W/D), total cells, PMN(%) and protein contents in BALF were determined after treatment. Results The rabbits injuryed with LPS in inhaling 20 ppm NO or iv infusing Milrinone could rapidly reduced mPAP and Qs/Qt, increase PaO2,NO without inducing significant change of mSAP. Compared with the LPS control, total cells, PMN(%), and protein contents in the BALF significantly decrease too. These results suggest that inhaled NO or iv infused Milrinone could attenuate LPS-induced ALI and pu