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等量海水与淡水淹溺对兔肺损伤作用的比较
张新红,段蕴铀*,芮萌,王海龙,王宇
0
(第二军医大学海军临床医学院,海军总医院呼吸内科,北京 100037)
摘要:
目的:比较等量海水与淡水灌注对兔肺损伤程度的影响。 方法:健康成年新西兰兔24只,随机分为3组(n=8) :对照组、海水灌注组(经气管插管灌注配方海水2 ml/kg,约5 min灌注完) 、淡水灌注组(同海水灌注组方法灌注淡水2 ml/kg)。连续180 min观察各组灌注前后呼吸频率、体循环参数、动脉血气和血清肿瘤坏死因子α(TNF-α) 、IL-6的变化。实验终点处死动物,观察肺泡灌洗液细胞计数和分类、肺组织湿/干质量比、肺微血管通透指数、肺病理组织学等。 结果:灌注后动物呼吸明显增快(P<0.01),体循环平均压下降(P<0.01),导致低氧血症及低碳酸血症,血清TNF-α、IL-6等炎症因子水平增高(P<0.01),肺组织病理损伤重,且海水组较淡水组变化显著且持久;海水组肺组织湿/干质量较其他两组增大、肺微血管通透指数较其他两组增高(P<0.05),支气管肺泡灌洗液中细胞数量较对照组增多(P<0.01),肺损伤程度明显重于淡水灌注组。结论:等剂量海水与淡水灌注比较,海水致兔的肺损伤程度重,病情发展快,病变更持久。
关键词:  海水  淡水  溺水  肺损伤
DOI:10.3724/SP.J.1008.2009.01013
投稿时间:2008-12-29修订日期:2009-03-12
基金项目:全军“十一五”科研计划(06-3305) .
Comparison of lung injuries induced by drowning with equal volume of seawater and freshwater in rabbits
ZHANG Xin-hong,DUAN Yun-you*,RUI Meng,WANG Hai-long,WANG Yu
(Department of Respiratory Medicine,General Hospital of Navy,Naval Clinical Medical College of Second Military Medical University,Beijing 100037,China)
Abstract:
Objective:To compare the lung injuries caused by drowning with equal volume of seawater and freshwater in rabbits.Methods: Twenty-four healthy New Zealand rabbits were randomly allocated to three groups (n=8):control group(CG), seawater-drowning group (infused with seawater, 2 ml/kg ) and freshwater-drowning group (infused with freshwater, 2 ml/kg).All rabbits were observed for 3 hours for breathing frequency, heart rate, mean arterial pressure (MAP), blood gas analysis and levels of TNF-α and IL-6.Pulmonary histopathology,ratio of wet/dry lung weight and permeation index of pulmonary capillary were recorded after the animals were sacrificed at the end of the experiment.Results: After infusion of seawater or freshwater, the respiration rates, serum levels of TNF-α and IL-6 were significantly increased (P<0.01), and the MAP was decreased (P<0.01), leading to hypoxemia and hypocapnia. Lung injuries were noticed in both seawater-drowning group and freshwater-drowning groups, with those in the former more persistent. The wet/dry ratio and permeation index of lung capillary were significantly increased after infusion in the seawater group compared with those in the other two groups (P<0.05). The cell number in the bronchoalveolar lavage fluid was significantly larger in the seawater-drowning group compared with that in the control group (P<0.01), and the lung injury was more severe than that in the freshwater group.Conclusion: Seawater infusion can lead to more serious and persistent lung injury in rabbits compared with equal volume of freshwater.
Key words:  seawater  freshwater  drowning  lung injuries