Thébaud B, Tibboel D, Rambaud C, Mercier J C, Bourbon J R, Dinh-Xuan A T, Archer S L
Réanimation Néonatale, Hôpital Antoine Béclère, 92141 Clamart, France.
Am J Physiol. 1999 Aug;277(2):L423-9. doi: 10.1152/ajplung.1999.277.2.L423.
Congenital diaphragmatic hernia (CDH) is a major cause of refractory respiratory failure in the newborn. Pulmonary hypoplasia often limits survival. Vitamin A (Vit A) is an important signal for lung growth. We hypothesized that antenatal treatment with Vit A would stimulate lung growth and decrease mortality in experimental CDH induced in rats by ingestion of the herbicide nitrofen (2, 4-dichlorophenyl-p-nitrophenyl ether). Nitrofen was administered to pregnant rats on day 12 of gestation (term 22 days). Rats were assigned to five groups: three groups received one dose of oral antenatal Vit A (15,000 IU) before (day 10), concomitant with (day 12), or after (day 14) nitrofen administration; one group received only nitrofen; and a control group received vehicle (olive oil). The incidence of CDH was markedly lower in all groups receiving Vit A (day 10, 44%; day 12, 20%; and day 14, 40%) compared with the nitrofen-treated group (84%; P < 0.05). The 72-h survival was higher in all 3 Vit A-treated groups (day 10, 40%; day 12, 58%; and day 14, 70%) compared with the nitrofen-treated group (16%; P < 0.05). Lung-to-body weight ratio and radial saccular count were significantly increased by Vit A. Antenatal treatment with Vit A lowers the incidence and severity of experimental CDH and increases lung growth and maturation.
先天性膈疝（CDH）是新生儿难治性呼吸衰竭的主要原因。肺发育不全常常限制了存活率。维生素A（Vit A）是肺部生长的重要信号。我们假设产前给予Vit A可刺激肺部生长，并降低大鼠摄入除草剂硝呋烯草胺（2,4 - 二氯苯基 - 对硝基苯基醚）诱导的实验性CDH的死亡率。在妊娠第12天（孕期22天）给怀孕大鼠施用硝呋烯草胺。将大鼠分为五组：三组在硝呋烯草胺给药前（第10天）、给药同时（第12天）或给药后（第14天）接受一剂口服产前Vit A（15,000 IU）；一组仅接受硝呋烯草胺；对照组接受赋形剂（橄榄油）。与硝呋烯草胺治疗组（84%；P<0.05）相比，所有接受Vit A的组（第10天，44%；第12天，20%；第14天，40%）的CDH发生率明显较低。与硝呋烯草胺治疗组（16%；P<0.05）相比，所有3个Vit A治疗组（第10天，40%；第12天，58%；第14天，70%）的72小时存活率更高。Vit A显著增加了肺与体重比和肺泡囊计数。产前给予Vit A可降低实验性CDH的发生率和严重程度，并促进肺生长和成熟。
