Parker James C, Townsley Mary I
Department of Physiology, MSB 3074, University of South Alabama, Mobile, AL 36688-0002, USA.
Am J Physiol Lung Cell Mol Physiol. 2004 Feb;286(2):L231-46. doi: 10.1152/ajplung.00049.2003.
Lung injury is a broad descriptor that can be applied to conditions ranging from mild interstitial edema without cellular injury to massive and fatal destruction of the lung. This review addresses those methods that can be readily applied to rats and mice whose small size limits the techniques that can be practically used to assess injury. The methodologies employed range from nonspecific measurement of edema formation to techniques for calculating values of specific permeability coefficient for the microvascular membrane in lung. Accumulation of pulmonary edema can be easily and quantitatively measured using gravimetric methods and indicates an imbalance in filtration forces or restrictive properties of the microvascular barrier. Lung compliance can be continuously measured, and light and electron microscopy can be used regardless of lung size to detect edema and structural damage. Increases in fluid and/or protein flux due to increased permeability must also be separated from those due to increased filtration pressure for mechanistic interpretation. Although an increase in the initial lung albumin clearance compared with controls matched for size and filtration pressure is a reliable indicator of endothelial dysfunction, calculated alterations in capillary filtration coefficient K(f,c), reflection coefficient sigma, and permeability-surface area product PS are the most accurate indicators of increased permeability. Generally, PS and K(f,c) will increase and sigma will decrease with vascular injury, but derecruitment of microvascular surface area may attenuate the affect on PS and K(f,c) without altering measurements of sigma.
肺损伤是一个宽泛的描述词,可用于描述从无细胞损伤的轻度间质性水肿到肺部严重致命性破坏等各种情况。本综述探讨了那些可轻易应用于大鼠和小鼠的方法,因其体型较小,限制了可实际用于评估损伤的技术。所采用的方法从水肿形成的非特异性测量到计算肺微血管膜特定通透系数值的技术不等。肺水肿的蓄积可使用重量法轻松且定量地测量,这表明微血管屏障的滤过力或限制性特性失衡。肺顺应性可连续测量,且无论肺的大小如何,均可使用光学显微镜和电子显微镜来检测水肿和结构损伤。为了进行机制解释,因通透性增加导致的液体和/或蛋白质通量增加也必须与因滤过压增加导致的通量增加区分开来。尽管与大小和滤过压匹配的对照组相比,初始肺白蛋白清除率增加是内皮功能障碍的可靠指标,但计算得出的毛细血管滤过系数K(f,c)、反射系数sigma和通透表面积乘积PS的变化是通透性增加的最准确指标。一般来说,随着血管损伤PS和K(f,c)会增加,而sigma会降低,但微血管表面积的减少可能会减弱对PS和K(f,c)的影响,而不会改变sigma的测量值。