胸部撞击伤、内毒素血症及其复合损伤对大鼠肺血管通透性的影响

目的 观察大鼠胸部撞击伤、内毒素血症及其复合损伤时肺组织微血管通透性变化规律。方法 80只Wistar大鼠随机分为撞击伤组，内毒素组、撞击伤加内毒素组及对照组。利用荧光分光光度计测定肺组织在各损伤情况下荧光素钠（FINα）的含量，以定量反映肺组织微血管的通透性变化。结果 在撞击伤组和复合致伤组撞击侧肺（右肺）早期血管通透性明显升高（伤后0.5h），非撞击侧肺（左肺）在观察点的晚期明显升高并达到峰值（伤后8h），非撞击侧肺在复合致伤组血管通透性升高最大，内毒素血症组次之，撞击伤最小。结论 肺微血管通透性改变的差异，说明3种致伤因素所致的病理生理过程不同，测定荧光素钠能够有效反映微血管通透性的变化。

Changes of lung microvascular permeability in blunt chest trauma, endotoxemia and their combined injury in rats

Objective To observe the changes of the microvascular permeability after blunt chest trauma (BCT), endotoxemia and their combined injury in rats. Methods After the establishment of the rat models of BCT, endotoxemia and their combined injury in the right lungs, the fluorescein sodium (FINa) content was measured with flurospectrophotometer in lungs 0.5, 1, 4 and 8 h after injury. Results There was an early obvious increase of the microvascular permeability in the impact lateral (peak at half an hour after injury), and a delayed increase in the contralateral lung (peak at the 8th h) in the BCT group. The FINa content was higher in endotoxemia group than in the BCT group( P <0.05), and lower than that in the combined injury group( P <0.05) in the contralateral lung. Conclusion Results indicate that there were different pathophysiologic processes among the 3 kinds of injury and the FINa content is a useful index to manifest the changes of microvascular permeability in tissues.