烟雾吸入伤家兔血中性粒细胞游离钙的变化及粉防己碱的作用

本文探讨了血中性粒细胞(PMN)游离钙水平〔Ca~(2+〕_i的变化与烟雾吸入性损伤的关系,同时还观察了钙拮抗剂粉防己碱对游离钙水平的影响与减轻吸入伤作用的关系。发现致伤后,血PMN数目有一短暂下降后持续升高,支气管肺泡灌洗液中PMN数目却明显增加;血PMN〔Ca~(2+)〕_i水平也明显增加。粉防己碱可以减少肺内PMN数目,降低血PMN〔Ca~(2+)〕_i水平,并且减轻吸入性损伤。提示PMN的活化与吸入伤的病理生理改变密切相关,粉防己碱可能是通过降低PMN〔Ca~(2+)〕_i水平,调节PMN功能,发挥其治疗作用。     

粒细胞NADPH氧化酶在犬烟雾吸入伤中的变化及意义

本实验利用犬烟雾吸入伤模型。观察了致伤前后粒细胞NADPH氧化酶活性的变化,显示其伤后活性增加,提示粒细胞及其活性氧代谢产物参与了犬烟雾吸入性肺损伤的发生发展,同时观察了血气、病检,肺含水量等指标,证实动物存在严重吸入性肺损伤。     

粉防己碱对吸入伤家兔肺表面活性物质活性的影响及意义

本文探讨了肺泡表面活性物质变化与兔吸入伤肺水肿的关系;同时,还探讨了钙拮抗剂粉防己碱(Tet)对肺的保护作用与减少肺表面活性物质破坏的关系。结果发现:致伤后肺泡表面活性物质下降同时,PaO_2下降,PaCO_2升高,肺血管外水量也显著增加。病理检查示肺部炎症水肿性改变。Tet治疗组,肺表面活性物质破坏减少,血气改善,肺部炎症及水肿减轻。提示Tet减轻肺损伤的作用,至少部分是通过减少肺表面活性物质破坏。并提出Tet可能是通过抑制磷脂酶A_2活性,减少肺表面活性物质分解而发挥作用的假设。     

粒细胞在犬烟雾吸入性肺损伤中的作用

利用重度犬烟雾吸入伤模型,观察了血中粒细胞的动态变化,及其在烟雾吸入性肺损伤中的作用。伤后血中粒细胞很快向肺内聚集和浸润;多核粒细胞(PMN)对自体细胞的毒性效应显著增强;PMN释放的髓过氧化物酶不断增加;代表氧自由基产生的PMN化学发光显著改变;这些变化均先于肺损伤,与其损伤时相基本一致。提示肺内粒细胞聚集和浸润在吸入性肺损伤中具有重要作用,颗粒酶和氧自由基可能是粒细胞介导肺损伤的效应因素。     

Changes of length of elastic fibers in rabbit lungs after smoke inhalation injury.

Pulmonary morphometry was determined in rabbit lungs after smoke inhalation. Twenty-four hours after injury, changes of the total lung volume (TLV) and the total length of all parenchymal elastic fibers (LT) were measured. Concomitant changes in arterial blood gas levels and pathomorphology of lung tissues were also studied. It was found that alveolar walls were broken and became thinner, and that alveoli were dilated. TLV was markedly increased and LT was markedly decreased as compared to normal lungs (P less than 0.05). These findings suggest that proteinases, especially elastase, released from phagocytes may play an important role in acute lung injury after smoke inhalation.

     

Effects of Ginsenosides and Ketoprofen on Smoke Inhalation Injury in Rabbits and Rats

Six hours after smoke inhalation injury in rabbits, the permeability of pulmonary vesselsand the aggregation of circulating platelets increased markedly accompanied with apparent patholog-ical changes in the trachea and lungs. Fifteen minutes after smoke inhalation injury in rabbits, an intravenous dose of ginsenosides or ketoprofenwas given to the animals respectively. 6 hours after medication, it was found that both the drugscould significantly alleviate the platelet aggregation, but only ginsenosides could alleviate theaugmentation of pulmonary vascular permeability and the pathological lesions in the trachea andlungs. In those rats injured by smoke inhalation, l hour after an intravenous dose of ginsenosides, theplasma PGI_2 level was elevated and TXA_2/PGI_2 ratio decreased significantly.     

Effects of early bronchoalveolar lavage fluid collected from dogs with smokeinhalation injury on the lungs of rats

Whether early massive bronchoalveolar lavage can remove the harmful substances from the lungs injured with smoke inhalation remains uncertain. This study was designed to observe the effects of early massive bronchoalveolar lavage fluid (BALF) on the healthy lungs in rats. Methods: Mongrel dogs were inflicted with severe smoke inhalation injury.. The injured lungs were lavaged with large amount of normal saline in the first hour after injury and the BALF was collected. The BALF was injected into the healthy lungs of 30 rats (group C) in the dosage of 5 ml/kg. The functions and pathological changes of the lungs were observed 24 h after perfusion with the BALF. The data were compared with those of 23 rats (group B) whose lungs were perfused with the BALF collected from normal dogs and those of 21 rats (group A) whose lungs were perfused with normal saline. Results: The mortality rate 24 h after lung perfusion was higher in group C than in groups A and B. The survivors of group C exhibited fluctuation of respiratory rate (RR), remarkable decrease of PaO2, significantly higher content of lung water, decrease of total static pnlmonary, compliance and pulmonary expansion index, and increasse of inflammatory cytokines in the tissues of lungs. Only slight mechanic obstructive effect on the airway was observed in rats of group A and B. The pathological changes of the lungs of the rats in group C were similar to those of the dogs with actual smoke inhalation injury.. Conclusion: Our findings indicate that the BALF collected from dogs with acute severe smoke inhalation injury, in the early stage after injury injured the normal lungs of rats with the bioactive substances in the BALF. These findings show us that it is a valuable therapeutic procedure to apply massive bronchoalveolar fluid lavage in the early stage after inhalation injury.     

军用密闭舱室烟雾吸入致雄性大鼠心、肺、肝、肾损伤的观察

目的 探讨军用密闭舱室非金属材料燃烧释放的有毒烟雾对雄性大鼠心、肺、肝、肾损伤的特点.方法 建立密闭舱室内动物烟雾吸入模型,将36只雄性SD大鼠按随机数字表法分为对照组及烟雾吸入后1、6、24、72 h和7d组,对照组动物于染毒箱内自由呼吸新鲜空气10 min,染毒组动物于染毒箱内连续吸入烟雾10 min,观察烟雾吸入后动物的中毒症状、血压、心率、血气、血清生化等指标.结果 烟雾吸入后,动物立刻出现呼吸节律改变、呼吸困难等CO中毒表现;烟雾吸入后1h大鼠心率显著下降(P＜0.05),pCO2显著升高(P＜0.05),pO2显著降低(P＜0.05);烟雾吸入后1～72 h组动物谷丙转氨酶(ALT)均显著升高(P＜0.05),其中6h时达峰值(P＜0.01);烟雾吸入后各组AST、LDH、α-HBDH、CK及CK-MB等心肌酶谱指标均持续升高,其中1h组各指标与对照组比较差异均有统计学意义(P＜0.05).结论 密闭舱室火灾烟雾吸入首先对大鼠的肺脏造成原发性损伤,心、肝、肾产生继发性的功能损害,且上述功能损害主要发生在烟雾吸入后“24h”窗口期内,其后由于机体代偿可逐渐恢复至正常.     

脂质过氧化在烟雾吸入性肺损伤机制中的作用

本文观察了脂质过氧化在犬(n=16)烟雾吸入性肺损伤机制中的作用。测定了动脉血SOD活性、动脉血浆MDA及呼出气乙烷和PaO_2及EVLW的变化。结果表明,本模型伤后早期出现了肺水肿和急性肺功能障碍。MDA及乙烷伤后显著增加,伤后30min及24h出现两峰值,SOD活性办增加。提示伤后早期氧自由基增加,肺脂质过氧化亢进。MDA及乙烷的第一个峰值与早期肺损伤及应激反应有关,第二个峰值与肺部感染有关。MDA、乙烷及SOD活性变化规律与PaO_2及EVLW相同。表明氧自由基导致的脂质过氧化可能参与了烟雾吸入伤后肺损伤发生和发展。     

MDL74405对实验性烟雾吸入伤大鼠血浆及组织MDA水平的影响

本研究采用大鼠烟雾吸入伤模型，观察了抗氧化剂维生素Ｅ（Ｖｉｔ Ｅ）同系物ＭＤＬ ７４４０５（０．２，１，５ｍｇ／ｋｇ，气管内给药）对吸入性损伤的疗效。结果发现，ＭＤＬ ７４４０５能明显降低血浆，肺、肝、心和小肠组织脂质过氧化物丙二醛（ＭＤＡ）水平，减轻气管及肺组织损伤，使氧分压（ＰａＯ２）升高，二氧化碳分压（ＰａＣＯ２）下降，改善呼吸功能，且疗效比Ｖｉｔ Ｅ好，可能与ＭＤＬ ７４４０５的强大清除自     

早期生理盐水全肺灌洗治疗烟雾吸入伤犬的近期效果

目的 探讨早期大容量生理盐水全肺灌洗治疗重度烟雾吸入伤犬的近期效果。方法 犬急性重度锯木屑燃烧烟雾吸入伤后1h进行生理盐水左肺大容量灌洗，30min后行右侧肺灌洗，随后PEEP控制呼吸24h。检测肺灌洗对犬病程中肺功能、离体脏器病理和生化改变的影响。结果 肺灌洗犬肺组织含水量显著增加而心脏、肾脏组织含水量有减少趋势，血浆和肺组织匀浆中细胞因子、自由基代谢产物及炎症反应相关酶含量和活力升高的幅度均小于未灌洗犬。但肺灌洗犬伤后24h内肺功能未表现出改善作用，表现在肺灌洗后PaO2始终低于未灌洗犬。结论 肺灌洗可减轻吸入伤原发性损害和继发性全身炎症反应，但肺泡积水影响气体交换导致近期肺功能低下。如何避免这一不良影响是肺灌洗疗法有效使用前必须解决的问题。     

The Effects of Ginsenosides on Smoke Inhalation Injury in Rats

A rat model was used to explore the therapeutic effects of ginsenosides (GS)on smoke inhalation long injury.It was found that GS could markedly alleviate the in-crease of pulmonary microvascular permeability (PMVP),reduction of protein and leu-cocyte content in the bronchoalveolar lavage fluid (BALF) of the smoke inhalation injur-ed rats.Histopathological studies of the lungs revealed that GS could distinctly reduceleucocyte accumulation in the vessels,interstitial infiltration of leucocytes,interstitial andintra-alveolar edema,hemorrhage and vascular congestion.Meanwhile,GS could inhibitthe elevation of malondialdehyde (MDA) in the lungs and serum and reverse the decrea-sed activity of superoxide dismutase (SOD) in the lungs after smoke inhalation.In addi-tion experiments in vitro also showed the inhibition of lipid peroxidation in lung homo-genate and elimination of superoxide anions hydroxyl radicals effectively by GS in properdoses.These results imply that there is close interrelationship between the therapeuticefficiency of GS on smoke inhalation lung injury and its capability of antioxidation.     

人参皂甙和酮布芬对烟雾吸入性肺损伤的影响

家兔烟雾吸入伤后6h,肺血管通透性和循环中血小板聚集率均明显增加,气管和肺部也有明显病变。治疗组于伤后15min静注人参总皂甙或酮布芬后6h,虽然两种药物均使循环中血小板聚集率显著降低,但只有人参总皂甙能明显降低伤后增加的肺血管通透性和减轻气管和肺部的病变。大白鼠在类似的实验条件下,人参总皂甙给药后1h,可使血中PGI_2水平升高,TXA_2/PGI_2的比值明显下降。     

烟雾吸入伤后肺内磷脂酶A2活性的变化及意义

采用大鼠烟雾吸入伤模型，动态观察了伤后支气管肺泡灌洗液（ＢＡＬＦ）及肺组织中磷脂酶Ａ２（ＰＬＡ２）活性的变化，辅以动脉血气分析，肺水量及ＢＡＬＦ中总蛋白（ＴＰ）和白蛋白（Ａｌｂ）含量测定，结果发现，动物伤后出现急性呼吸衰竭和严重肺水肿，ＢＡＬＦ中ＴＰ及Ａｌｂ含量均显著增加：ＢＡＬＦ和肺组织中ＰＬＡ２活性亦明显升高，提示ＰＬＡ２可能通过直接作用及介导脂类介质生成而与烟雾吸入性肺损伤的发生发展。     

早期大容量肺灌洗对犬重度单肺吸入伤引起的对侧肺损害的影响

目的：研究大容量灌洗对犬一侧肺急性重度烟雾吸入伤引起的对侧肺损害的影响,求证早期肺灌洗减轻吸入伤犬肺继发性炎症反应的有效性。方法：建立犬左肺单侧急性重度烟雾吸入伤模型,伤后1h对伤肺进行生理盐水大容量灌洗。观察自主呼吸24h间灌洗组犬与未灌洗组犬双肺换气功能,比较24h后两组犬两侧肺标本之病理学和病理生理学变化程度。结果：左肺灌注总量250ml,简单负压吸引后单肺灌注液存留量90-140ml。伤后立即灌洗组与未灌洗组犬PaO2均显著下降,灌洗组犬灌洗后PaO2立即进一步下降,2h后逐渐回升,伤后24h时已反超未灌洗组犬;两组犬左肺均呈现重度肺水肿及肺出血,右肺呈轻-中度肺水肿,灌洗组犬右肺肺水含量小于未灌洗组犬,右肺动、静态顺应性大于未灌洗组犬。结论：早期大容量灌洗可减轻犬一侧肺急性重度烟雾吸入伤时对侧肺损害程度,即有效减少了吸入伤犬肺后续炎症反应。     

Studies of the MDL 74405 effects on plasma and tissue MDA level after inhalation injury in rats

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烟雾吸入伤大鼠肺组织85KD磷脂酶A2变化初探

目的探讨85KD磷脂酶A2(85KDPLA2)在烟雾吸入伤大鼠肺组织中的表达与活性变化及其变化的可能机制.方法 85KDPLA2酶表达相对含量用酶联免疫吸附法测定;85KDPLA2活性用生化法测定.同时检测肺混合细胞浆钙浓度和肺匀浆髓过氧化物酶(MPO)活性.结果烟雾吸入伤后,肺匀浆85KDPLA2OD值从伤后1～24h均高于正常对照组、肺匀浆85KDPLA2活性变化与OD值变化相似,而混合细胞胞浆钙浓度和MPO活性分别从伤后1h和3h明显高于正常对照组,并持续到伤后24h(P<0.05).结论肺组织85KDPLA2酶蛋白表达,特别是活性增加可能是烟雾吸入伤后磷脂酶A2激活的重要原因之一,肺实质细胞与中性粒细胞可能是85KDPLA2产生的重要来源,而胞浆钙浓度增加可能参与了85KDPLA2的激活过程.     

氧合氟碳液早期肺灌洗对犬重度单肺吸入伤的影响--与生理盐水肺灌洗的比较

目的 与生理盐水肺灌洗比较，研究评价氧合氟碳液PFC早期肺灌洗治疗犬重度单肺吸入伤的优缺点。方法 建立犬左肺单侧急性重度烟雾吸入伤模型，伤后1h对伤肺进行氧合氟碳液PFC或生理不大容量灌洗。观察自主呼吸24h内犬双肺换气功能，肺病理和病理生理学变化程度，计算两种灌洗液的清洁效率。结果 （1）生理盐水和PFC肺灌洗均可有效清除下呼吸道，减轻吸入伤引起的原发性和继发性肺组织结构改变；（2）生理盐水灌洗犬左肺伤后24h肺功能无改善而右肺和全肺功能相对未灌洗犬有一定改善；（3）PFC肺灌洗清洁功能不及生理盐水，但灌洗犬近期肺功能显著优于生理盐水灌洗犬和吸入伤后自然演变组犬。结论 早期大容量肺灌洗可有效减少吸入伤犬肺继发性炎症反应，氧合氟碳液灌洗在显示近期综合疗效方面有优越性。     

烟雾吸入伤大鼠肺组织抗氧化酶活性和谷胱甘肽含量变化

目的观察烟雾吸入伤大鼠肺组织抗氧化酶活性和谷胱甘肽含量变化.方法建立大鼠烟雾吸入伤模型,将60只Wistar大鼠随机分成正常对照组,烟雾吸入伤1、3、6、12h和24h组,分取肺组织测定过氧化氢酶(CAT)、谷胱甘肽过氧化物酶(GSH-PX)、超氧化物歧化酶(SOD)活性和谷胱甘肽(GSH)含量.结果肺组织匀浆CAT活性在烟雾吸入伤后3、6h明显高于正常对照组(P<0.05、P<0.01),伤后12h、24h已低于正常对照组;GSH-PX活性伤后1h已明显高于正常对照组(P<0.01), 伤后3h达峰值,伤后12、24h明显低于正常对照组(P<0.05);SOD活性和GSH含量从烟雾吸入伤后1h开始明显低于正常对照组,一直持续到伤后24h(P<0.05,P<0.01).结论烟雾吸入伤后肺组织CAT、GSH-PX活性先增后减,而SOD活性和GSH含量持续降低,反映了肺内氧应激的强度和抗氧化物质的不同作用.     

犬烟雾吸入伤早期肺洗出液对大鼠肺损伤作用的研究

目的 研究犬烟雾吸入伤早期肺洗出液是否具有生物学活性及其活性强度的持续时间。方法 建立大急性重度烟雾吸入伤模型,伤后1h对伤肺进行生理盐水大容量灌洗,将一定量之洗出液经气管注入正常大鼠气道,观察自主呼吸24h间大鼠呼吸频率、血气及离体肺含水量和肺泡稳定性等变化。结果 与正常大鼠、等容量生理盐水或正常犬肺洗出液气道灌注大鼠相比,用烟雾吸入伤犬早期肺洗出液灌注大鼠气道24h内死亡率高;存活者RR波动大,PaO2显著下降;肺水含量高,静态总肺顺应性和肺扩张指数低提示肺泡稳定性差;肺组织氧化能力显著升高,总抗氧化能力显著下降。结论 犬烟雾吸入伤早期肺洗出液灌注大鼠气道可引起明确的损害反应,并表现出一定的小气道机械阻塞作用。洗出液具有肯定的生物学活性,引起的肺损害作用在灌注后24h已大部消除。