超声雾化吸入前列腺素E1在单肺通气期间的肺保护作用

【目的】研究超声雾化吸入前列腺素E1（PGE1）对单肺通气（OLV）患者的肺保护作用。【方法】选择40例OLV手术患者，随机分为两组，P组雾化吸入PGE1，C组为对照组。分别于OLV前10min（T0）、OLV45min（T1）、OLV90min（T2）抽动脉血与混合静脉血行血气分析，并于相应时点测定通气侧肺泡灌洗液（BALF）TNF-α，IL-8，IL-10的浓度。【结果】OLV后两组氧合指数（OI）均下降，但P组较C组下降缓慢，且P组T2较T1有所回升；而Qs／Qt则成相反的趋势；OLV后两组TNF-α，IL-8的浓度均升高，但P组较C组升高较少；IL-10两组OLV后均降低，但P组较C组降低较少。【结论】OLV期间吸入PGE1能改善氧合，降低肺内分流；并能下调IL-8、TNF-α，上调IL-10减轻肺泡炎性反应。

Lung Protection of Ultrasonic Atomizing Inhalation of PGE1 in Patients with One-lung Ventilation

Objective] To investigate the effect of ultrasonic atomizing inhalation of prostaglandin（PGE1 ） for lung protection in patients with one-lung＇ventilation （OLV）. Methods]Forty patients undergoing OLV were randomly divided into two groups with 20 patient in each group. Group P received ultrasonic atomizing inhalation of PGE1. Group C were taken as control group. Arterial blood and mixed venous blood at 10min before OLV（T0）, 45min after OLV（T1 ） and 90min after OLV（T2 ）were collected for the blood gas analysis. TNF-α,IL-8 and IL-10 in bronchoalveolar lavage fluid of ventilational lung were also measured at the same time by radioimmunoassay. Results] The oxygenation index was reduced after OLV in two groups, but decreased slowly in group P and then raised again slowly at T2. The Qs/Qt were increased in two groups, but increased slowly in group P and then dropped again slowly at T2. TNF-α and IL-8 levels in plasma in bronchoalveolar lavage fluid of ventilational lung were increased in two groups, but increased slowly in group P. IL-10 was reduced after OLV, but reduced slowly in group P. Conclusion] Inhaling PGE1 during OLV can improve the oxygenation, reduce the intrapulmonary shunt fraction, down regulate IL-8 and TNF-α levels, and up regulate IL-10 level in bronchoalveolar lavage fluid of ventilational lung.