Ishizaka A, Stephens K E, Segall G M, Hatherill J R, McDougall I R, Wu Z, Raffin T A
Department of Medicine, Stanford University Medical Center, CA 94305-5236.
Am Rev Respir Dis. 1990 Mar;141(3):631-9. doi: 10.1164/ajrccm/141.3.631.
The individual roles of pulmonary capillary endothelial and alveolar epithelial permeability in the pathogenesis of the adult respiratory distress syndrome (ARDS) are unclear. We developed a method for the sequential assessment of pulmonary macromolecule accumulation and small solute clearance in vivo using a gamma camera. We measured the exponential clearance coefficient of 111In-labeled diethylene triamine penta-acetate (111In-DTPA) to assess airway clearance of small solutes. We also calculated the exponential equilibration coefficient of 111In-labeled transferrin (111In-TF) to assess intrapulmonary accumulation of transferrin. We determined these parameters in guinea pigs with Escherichia coli peritonitis and compared them with a saline-treated control group, oleic-acid-treated groups, and a group treated with low molecular weight dextran Ringer solution. The pulmonary DTPA clearance and the intrapulmonary transferrin accumulation were significantly increased in the peritonitis group (29.4 +/- 8.2 x 10(-3) min-1, p less than 0.02, and 15.1 +/- 3.1 x 10(-3) min-1, p less than 0.02) when compared with the control group (3.1 +/- 0.8 x 10(-3) min-1 and 4.5 +/- 0.5 x 10(-3) min-1). These changes developed within 5.5 h of the initial insult. Neither increased extravascular lung water nor elevated pulmonary artery and left atrial pressures were detected in the peritonitis group. The low molecular weight dextran Ringer group did not show a significant increase in the pulmonary DTPA clearance and the intrapulmonary transferrin accumulation.(ABSTRACT TRUNCATED AT 250 WORDS)
肺毛细血管内皮和肺泡上皮通透性在成人呼吸窘迫综合征（ARDS）发病机制中的个体作用尚不清楚。我们开发了一种利用γ相机在体内序贯评估肺大分子蓄积和小溶质清除率的方法。我们测量了111铟标记的二乙三胺五乙酸（111In-DTPA）的指数清除系数，以评估小溶质的气道清除率。我们还计算了111铟标记的转铁蛋白（111In-TF）的指数平衡系数，以评估转铁蛋白在肺内的蓄积。我们在患有大肠杆菌性腹膜炎的豚鼠中测定了这些参数，并将其与生理盐水处理的对照组、油酸处理组和低分子量右旋糖酐林格液处理组进行比较。与对照组（3.1±0.8×10-3 min-1和4.5±0.5×10-3 min-1）相比，腹膜炎组的肺DTPA清除率和肺内转铁蛋白蓄积显著增加（29.4±8.2×10-3 min-1，p<0.02，和15.1±3.1×10-3 min-1，p<0.02）。这些变化在初始损伤后5.5小时内出现。腹膜炎组未检测到血管外肺水增加或肺动脉和左心房压力升高。低分子量右旋糖酐林格液组的肺DTPA清除率和肺内转铁蛋白蓄积未显示出显著增加。（摘要截短至250字）
