Bishop M J, Lamm W, Guidotti S M, Albert R K
Department of Anesthesiology, Department of Veterans Affairs Medical Service, Seattle, Washington.
J Appl Physiol (1985). 1992 Jul;73(1):272-5. doi: 10.1152/jappl.1992.73.1.272.
Unilateral pulmonary artery obstruction (PAO) for 24-48 h, followed by reperfusion, results in pulmonary edema and lung inflammation. We hypothesized that lung injury actually occurred during the period of PAO but, because of low microvascular pressures during the period of occlusion, was not detected until perfusion was reestablished. To test this hypothesis, we studied 14 rabbits divided into three groups: group I rabbits underwent sham occlusion of the left pulmonary artery for 24 h; group II rabbits underwent PAO but were not reperfused; and group III rabbits were subjected to PAO and then reperfused for 4 h. The fluid filtration coefficient measured during a zone 3 no-flow hydrostatic stress (pulmonary arterial pressure = pulmonary venous pressure, both greater than alveolar pressure) in group I lungs was less than that of lungs in either group II or III [0.52 +/- 0.02 (SE) ml.min-1.cmH2O.100 g wet wt-1 vs. 0.94 +/- 0.11 and 0.86 +/- 0.13 for groups II and III, respectively, P less than 0.05]. The wet-to-dry weight ratio of the left lung measured after the zone 3 stress was applied for 20 min was 6.90 +/- 0.09 in group I rabbits and 9.21 +/- 0.75 and 11.75 +/- 0.44 in groups II and III, respectively (P less than 0.05). Radiolabeled microspheres demonstrated that flow to the left lung was diminished after the period of PAO (38 +/- 4, 9 +/- 5, and 2 +/- 1% of cardiac output in groups I, II, and III, respectively; P less than 0.05 for group I vs. groups II and III).(ABSTRACT TRUNCATED AT 250 WORDS)
单侧肺动脉阻塞(PAO)24 - 48小时,随后再灌注,会导致肺水肿和肺部炎症。我们推测肺损伤实际上发生在PAO期间,但由于阻塞期间微血管压力较低,直到恢复灌注才被检测到。为了验证这一假设,我们研究了14只兔子,分为三组:第一组兔子左肺动脉假闭塞24小时;第二组兔子接受PAO但未再灌注;第三组兔子接受PAO然后再灌注4小时。在第一组肺脏的3区无血流流体静力压(肺动脉压 = 肺静脉压,两者均大于肺泡压)期间测量的液体滤过系数低于第二组或第三组肺脏的系数[分别为0.52±0.02(SE)ml·min⁻¹·cmH₂O⁻¹·100 g湿重⁻¹,第二组和第三组分别为0.94±0.11和0.86±0.13,P < 0.05]。在施加3区应力20分钟后测量的左肺干湿重比,第一组兔子为6.90±0.09,第二组和第三组分别为9.21±0.75和11.75±0.44(P < 0.05)。放射性标记微球显示,PAO期间后左肺血流减少(第一组、第二组和第三组分别为心输出量的38±4%、9±5%和2±1%;第一组与第二组和第三组相比,P < 0.05)。(摘要截断于250字)