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模拟半闭式潜水装具潜水后快速出水对大鼠肺功能、血气指标和炎症因子的影响
刘文武1,方以群1,刘霞1,钟伟杰2,俞旭华1,徐佳骏1,文宇坤1,李慈1*
0
(1. 海军军医大学(第二军医大学)海军特色医学中心潜水与高气压医学研究室, 上海 200433;
2. 上海交通大学医学院附属第九人民医院神经外科, 上海 200011
*通信作者)
摘要:
目的 研究32%氧-68%氮混合气不同方式暴露后快速减压出水对大鼠肺功能、血气指标和炎症指标的影响。方法 30只雄性SD大鼠随机分为5组(每组6只):正常对照组;实验1组,于40 m深度下呼吸32%氧-68%氮混合气4 h后快速减压出舱,出舱后即刻、3 h和24 h时检测肺功能;实验2组,高气压暴露方案与实验1组相同,出舱后即刻处死,取血进行血气分析,并检测炎症指标IL-1β、TNF-α、TGF-β和氧化应激指标4-羟基壬烯醛(4-HNE);实验3组,高气压暴露方案与实验1组相同,出舱后常压下呼吸100%纯氧30 min,检测肺功能后处死,取血进行血气分析及检测炎症指标和氧化应激指标;实验4组,于7 m深度下呼吸100%纯氧30 min,再于15 m深度下呼吸32%氧-68%氮混合气3 h,然后加压至40 m深度呼吸相同混合气10 min后快速减压,出舱后检测肺功能,处死后取血进行血气分析,并检测炎症指标和氧化应激指标。采用全身体积描记系统检测大鼠的肺功能,采用血气分析仪进行血气指标分析,采用试剂盒检测大鼠血液炎症指标和氧化应激指标。结果 高气压暴露后快速减压,大鼠呼吸频率增加,吸气和呼气时间缩短,最大吸气和呼气流速增加,每分钟通气量增加。出水后吸氧能改善上述呼吸功能变化,但仍存在一定的呼气阻力增加。入水后浅深度吸氧,逐步增加潜水深度,快速减压仍能导致一定程度肺损伤,主要表现为呼气和吸气阻力增加。结论 采用半闭式潜水装具潜水时,初始阶段浅深度呼吸纯氧或快速出水后常压呼吸纯氧对快速减压导致的肺不良影响具有一定的防治作用,但作用有限。
关键词:  半闭式潜水装具  快速上升  肺功能  血气分析  炎症细胞因子
DOI:10.16781/j.CN31-2187/R.20220228
投稿时间:2022-03-18修订日期:2022-12-22
基金项目:国家自然科学基金(81772015,81901912),国防科技创新特区项目(19-163-16-ZD-020-008-01,19-163-16-ZD-020-008-03).
Effects of fast ascent after simulated diving with semi-closed circuit rebreather on lung function, blood gas indicators and inflammatory factors in rats
LIU Wenwu1,FANG Yiqun1,LIU Xia1,ZHONG Weijie2,YU Xuhua1,XU Jiajun1,WEN Yukun1,LI Ci1*
(1. Department of Diving and Hyperbaric Medical Research, Naval Medical Center, Naval Medical University(Second Military Medical University), Shanghai 200433, China;
2. Department of Neurosurgery, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200011, China
*Corresponding author)
Abstract:
Objective To investigate the effects of exposure to 32% oxygen-68% nitrogen (mixed gas) with different protocols on the lung function, blood gas indicators and inflammatory factors in rats undergoing fast ascent. Methods Thirty male SD rats were randomly divided into 5 groups (n=6): normal control group, group 1 (rats were pressured with mixed gas at 40 m for 4 h, followed by rapid decompression, and lung function was detected at 0, 3 and 24 h after decompression), group 2 (the hyperbaric exposure protocol was the same as that in group 1, but rats were sacrificed immediately after decompression, and then blood was collected for detection of the blood gas indicators, inflammatory factors [interleukin 1β, tumor necrosis factor α, and transforming growth factor β] and oxidative stress indicator [4-hydroxynonenal]), group 3 (the hyperbaric exposure protocol was the same as that in group 1, but rats were exposed to normobaric 100% oxygen for 30 min after decompression. After the examination of the lung function, rats were sacrificed, and blood was collected for the examination of the blood gas indicators, inflammatory factors and oxidative stress indicator), and group 4 (rats were exposed to 100% oxygen at 7 m for 30 min, then to mixed gas at 15 m for 3 h and finally to mixed gas at 40 m for 10 min, followed by rapid decompression. After the examination of the lung function, rats were sacrificed, and blood was collected for the examination of the blood gas indicators, inflammatory factors and oxidative stress indicator). The lung function of the rats was examined by a whole body plethysmography system, blood gas analysis was performed by a blood gas analyzer, and the blood inflammatory factors and oxidative stress indicator of the rats were detected by kits. Results Fast ascent after hyperbaric exposure increased the respiratory rate, shortened the time of inspiration and expiration, increased the peak inspiratory and expiratory flow rates, and elevated the minute ventilation. Normobaric oxygen exposure after fast ascent improved the lung dysfunction, but the respiratory resistance was still increased as compared to baseline level. Fast ascent after hyperbaric exposure with oxygen inhalation at shallower water and increase of depth step by step could also cause damage to the lung function, which was characterized by the increase of expiratory and inspiratory resistance. Conclusion In the diving with semi-closed circuit rebreather, fast ascent may cause damage to the lung, which may be improved to a limited extent by short-term oxygen breathing in initial shallow water or normobaric 100% oxygen afetr fast ascent.
Key words:  semi-closed circuit rebreather  fast ascent  lung function  blood gas analysis  inflammatory cytokines