天津医药

天津医药 ›› 2017, Vol. 45 ›› Issue (12): 1248-1252.doi: 10.11958/20170621

• 实验研究 • 上一篇    下一篇

亚低温治疗对急性呼吸窘迫综合征犬肺功能的影响

崔嵩 1， 陆成全 2， 韩叶叶 1， 康志杰 3， 刘银辉 4   

  1. 基金项目： 大连市卫计委 2013 年资助项目 作者单位： 1 大连市中心医院外科 ICU （邮编 116033）； 2 锦州市疾病预防控制中心； 3 大连医科大学附属第二医院血液科； 4 大连医科大学 微生物教研室 作者简介： 崔嵩 （1978）， 男， 硕士， 副主任医师， 主要从事重症血液净化、 重症超声及 ICU 微生物组学等相关研究
  • 收稿日期:2017-06-01 修回日期:2017-11-08 出版日期:2017-12-15 发布日期:2017-12-15
  • 通讯作者: 崔嵩 E-mail:cuisong2008@qq.com
  • 基金资助:
    亚低温治疗感染性休克所致ARDS的实验研究

Efficacy of mild hypothermia therapy on pulmonary function in ARDS dogs

CUI Song1, LU Cheng-quan2， HAN Ye-ye1, KANG Zhi-jie3, LIU Yin-hui4   

  1. 1 Surgical ICU, Dalian Municipal Central Hospital, Dalian 116033, China; 2 Jinzhou City Center for Disease Control and Prevention; 3 Department of Hematology, the Second Hospital of Dalian Medical University; 4 Department of Microecology, Dalian Medical University
  • Received:2017-06-01 Revised:2017-11-08 Published:2017-12-15 Online:2017-12-15
  • Contact: Song CUI E-mail:cuisong2008@qq.com

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摘要： 目的 探讨亚低温治疗对急性呼吸窘迫综合征 （ARDS） 犬呼吸功能的影响。方法 25 只健康杂种犬随机 分为常温感染组 （12 只） 和亚低温感染组 （13 只)。2 组均通过股静脉泵入活大肠埃希菌制成高动力型感染性休克模 型。常温感染组在常温下继续观察， 亚低温感染组通过血管内降温实施亚低温治疗 （33 ℃±1 ℃）。2 组 0、 24、 48 h 通 过 PICCO 采集肺血流动力学参数， 呼吸机监测呼吸力学参数。72 h 后处死动物， 拍摄胸片及留取肺组织病理切片， 判断是否发生 ARDS。结果 观察至 72 h 时， 亚低温感染组及常温感染组分别有 4 只及 7 只发生 ARDS。2 组氧合 指数 （OI）、 氧分压 ［p （O2）］ 及肺静态顺应性 （Cst） 均随观察时间的延长逐渐降低， 血管外肺水指数 （EVLWI）、 肺血管通 透性指数 （PVPI）、 气道平台压 （Pplat） 及气道阻力 （Raw） 则随之逐渐升高 （均 P < 0.05）。亚低温感染组上述指标均明 显优于常温感染组。结论 亚低温治疗可以改善感染性休克犬的肺功能和肺血流动力学状态， 降低 ARDS 的严重 程度。

关键词: 休克, 脓毒性, 犬科, 血流动力学, 呼吸窘迫综合征, 成人, 肺功能, 亚低温, 感染性休克

Abstract: Objective To investigate the efficacy of mild hypothermia therapy on pulmonary function in acute respiratory distress syndrome (ARDS) dogs. Methods A total of 25 healthy dogs were included and randomly divided into two groups, mild hypothermia treatment group (experimental group, n=12) and normothermia treatment group (control group, n=13). The E. coli was pumped continuously into the canine femoral vein by micro pump to construct the septic shock model in two groups. The hypothermia experimental group was treated with hypothermia (33 ℃±1 ℃), and the control group was observed at room temperature. The pulmonary hemodynamic parameters and respiratory mechanics parameters were supervised by PICCO and respirator respectively at 0, 24 and 48 h during the ARDS progress. Moreover, chest X-ray and lung tissue biopsy were taken to confirm the diagnosis of ARDS after 72 h. Results Up to 72 h, ARDS was found in the experimental group (n=4) and the control group (n=7) respectively. The oxygenation index (OI), partial pressure of oxygen [p(O2)] and pulmonary static compliance (Cst) decreased gradually with the extension of time in two groups. On the contrary, the external venous lung water index (EVLWI), pulmonary vascular permeability index (PVPI) and airway resistance (Raw) increased gradually (P < 0.05). However, all the parameters were significantly better in mild hypothermia group than those of the normothermia group. Conclusion Mild hypothermia therapy can improve the pulmonary function and reduce the severity of ARDS in septic shock dogs.

Key words: shock, septic, canidae, hemodynamics, respiratory distress syndrome, adult, respiratory function, mild hypothermia, septic shock