Xinmin Ding, Yunyou Duan, Chaosheng Peng, Huasong Feng, Pingkun Zhou, Jiguang Meng, Zhiqian Xue, Qinzhi Xu
Department of Respiratory Disease, Naval General Hospital of PLA, Beijing 100037, China.
Pharmacol Res. 2006 Apr;53(4):372-9. doi: 10.1016/j.phrs.2006.01.006. Epub 2006 Feb 28.
There is very little evidence on the value of giving corticoids in cases of seawater drowning induced acute lung injury/acute respiratory distress syndrome (ALI/ARDS). Therefore, this study aimed to investigate whether dexamethasone treatment can attenuate seawater instillation-induced acute lung injury in rabbits. Seawater (4 ml/kg body weight) was instilled into the lower trachea of ventilated, anesthetized rabbits. Then these rabbits were assigned randomly 20 min later to receive intravenous injection of 1mg/kg body weight of dexamethasone (dissolving in 2 ml of normal saline) or 2 ml of normal saline. All animals demonstrated immediate drops in arterial oxygen tension (PaO2) and the total thoracic compliance, which were significantly improved after 2 h of dexamethasone treatment. Histopathological study also indicated that dexamethasone treatment markedly attenuated lung histopathological changes, alveolar hemorrhage and inflammatory cells infiltration with evidence of decreasing of myeloperoxidase (MPO) activity and tumor necrosis factor-alpha (TNF-alpha) concentration in lung tissue. In addition, dexamethasone treatment reduced extravascular lung water and lung epithelial-endothelial barrier permeability, up-regulated the expression of surfactant protein-A (SP-A) and alpha-epithelial Na+ channel, and increased Na+/K+-adenosine triphosphatase (Na+/K+-ATPase) activity and Na+/K+-ATPase-alpha1 protein abundance. Thus, these data indicate that dexamethasone treatment might be of benefit in patients with seawater aspiration-induced ALI.
关于在海水淹溺所致急性肺损伤/急性呼吸窘迫综合征（ALI/ARDS）病例中给予皮质类固醇的价值，证据非常少。因此，本研究旨在探讨地塞米松治疗是否能减轻海水注入诱导的家兔急性肺损伤。将海水（4毫升/千克体重）注入通气、麻醉的家兔的下气管。然后，20分钟后将这些家兔随机分组，分别接受静脉注射1毫克/千克体重的地塞米松（溶于2毫升生理盐水中）或2毫升生理盐水。所有动物的动脉血氧分压（PaO2）和总胸壁顺应性均立即下降，地塞米松治疗2小时后显著改善。组织病理学研究还表明，地塞米松治疗显著减轻了肺组织病理学变化、肺泡出血和炎症细胞浸润，肺组织中髓过氧化物酶（MPO）活性和肿瘤坏死因子-α（TNF-α）浓度降低。此外，地塞米松治疗减少了血管外肺水和肺上皮-内皮屏障通透性，上调了表面活性蛋白-A（SP-A）和α-上皮钠通道的表达，并增加了钠/钾-腺苷三磷酸酶（Na+/K+-ATP酶）活性和Na+/K+-ATP酶-α1蛋白丰度。因此，这些数据表明地塞米松治疗可能对海水吸入所致ALI患者有益。
