Li Bailing, Chai Jiake, Hu Quan, Zhang Xulong, Zhang Donghai, Ma Li, Yu Yonghui, Liu Lingying
Graduate School of Tianjin Medical University, Tianjin 300070, China.
Department of Burns and Plastic Surgery, Burns Institute, First Affiliated Hospital, General Hospital of PLA, Beijing 100037, China. Email:
Zhonghua Yi Xue Za Zhi. 2015 Jan 13;95(2):133-7.
To observe the therapeutic effects of exogenous pulmonary surfactant (PS) on acute lung injury induced by severe burn-blast combined injury in a rat model.
A total of 180 adult male SD rats were randomly divided into 3 groups of sham, treatment and control (n=60 each). Severe burn-blast combined injury was induced by inflicting rats with a moderate blast injury and a full-thickness burn injury of 25% total body surface area. The treatment and control groups received exogenous PS (2 ml/kg) and saline (2 ml/kg) by trachea respectively. At the time points of 0, 6, 24, 48 and 72 h, 12 rats per timepoint in each group underwent PaO2, PaCO2 and pulmonary function tests respectively. And they were then sacrificed for other analyses. Lung tissues were harvested for histological studies. Their arterial blood samples were collected for blood gas analysis. All data were expressed as mean ± standard deviation and analyzed with SPSS 20.0 (SPSS Inc., Chicago, IL, USA). The differences were considered to be statistically significant at P < 0.05.
After removing death drain during the experiment, 8 rats were put equally into five phase points of the last three groups, the results were analyzed statistically. PaO2: At each timepoint of 6, 24, 48, 72 h, the control group PaO2 were obviously lower than the sham group ((69.55 ± 5.11), (62.05 ± 6.54), (53.24 ± 7.65), (50.00 ± 7.45) vs (93.75 ± 3.41), (94.25 ± 2.19), (93.63 ± 2.33), (93.25 ± 1.83) mmHg (1 mmHg = 0.133 kPa), all P < 0.01); at 6 h treatment group was close to sham group ((92.63 ± 3.74) vs (93.75 ± 3.41) mmHg, P=0.594); at 6 h control group PaO2 decreased to 70 mmHg and then gradually declined. And at each timepoint the treatment group PaO2 was significantly higher than the control group ((92.63 ± 3.74), (87.50 ± 3.34), (78.75 ± 3.11), (71.38 ± 3.74) vs (69.55 ± 5.11), (62.05 ± 6.54), (53.24 ± 7.65), (50.00 ± 7.45) mmHg, all P < 0.01); PaCO2: treatment group PaCO2 was lower than that of control group at 6, 24, 48 h ((45.50 ± 6.79), (49.38 ± 7.52), (54.13 ± 4.82) vs (53.25 ± 2.76), (59.50 ± 6.61), (63.60 ± 7.33) mmHg, all P < 0.01), both treatment and control groups were significantly higher than those in the sham group ((59.63 ± 6.87), (68.88 ± 6.85) vs (36.38 ± 1.85) mmHg, all P < 0.01). No difference existed between the control and treatment groups (P = 0.051). Deep inspiratory capacity, central airway resistance, lung compliance and tissue elasticity, treatment group was significantly better than control group at 24 h (P < 0.05). And it was close to sham group (P > 0.05). The treatment group alveolar structural damage and pulmonary hemorrhage and edema were better than those in the control group.
Exogenous pulmonary surfactant (PS) can improve oxygenation and alleviate pulmonary edema and pulmonary capillary membrane permeability of rats with severe burn blast combined injury.
观察外源性肺表面活性物质（PS）对重度烧伤 - 冲击复合伤致大鼠急性肺损伤的治疗效果。
将180只成年雄性SD大鼠随机分为假手术组、治疗组和对照组，每组60只。通过对大鼠造成中度冲击伤和25%体表面积的全层烧伤，诱导重度烧伤 - 冲击复合伤。治疗组和对照组分别经气管给予外源性PS（2 ml/kg）和生理盐水（2 ml/kg）。在0、6、24、48和72 h时间点，每组每个时间点取12只大鼠分别进行动脉血氧分压（PaO₂）、动脉血二氧化碳分压（PaCO₂）及肺功能检测，然后处死进行其他分析。取肺组织进行组织学研究，采集动脉血样本进行血气分析。所有数据以均数±标准差表示，采用SPSS 20.0（美国伊利诺伊州芝加哥市SPSS公司）进行分析。P < 0.05认为差异有统计学意义。
实验过程中去除死亡引流后，将最后三组各8只大鼠等分为五个时间点，对结果进行统计学分析。PaO₂：在6、24、48、72 h各时间点，对照组PaO₂明显低于假手术组（（69.55±5.11）、（62.05±6.54）、（53.24±7.65）、（50.00±7.45）mmHg比（93.75±3.41）、（94.25±2.19）、（93.63±2.33）、（93.25±1.83）mmHg（1 mmHg = 0.133 kPa），均P < 0.01）；6 h时治疗组接近假手术组（（92.63±3.74）比（93.75±3.41）mmHg，P = 0.594）；6 h时对照组PaO₂降至70 mmHg后逐渐下降。各时间点治疗组PaO₂均显著高于对照组（（92.63±3.74）、（87.50±3.34）、（78.75±3.11）、（71.38±3.74）比（69.55±5.11）、（62.05±6.54）、（53.24±7.65）、（50.00±7.45）mmHg，均P < 0.01）；PaCO₂：治疗组在6、24、48 h时PaCO₂低于对照组（（45.50±6.79）、（49.38±7.52）、（54.13±4.82）比（53.25±2.76）、（59.50±6.61）、（63.60±7.33）mmHg，均P < 0.01），治疗组和对照组均显著高于假手术组（（59.63±6.87）、（68.88±6.85）比（36.38±1.85）mmHg，均P < 0.01）。对照组和治疗组之间无差异（P = 0.051）。深吸气量、中心气道阻力、肺顺应性和组织弹性，治疗组在24 h时显著优于对照组（P < 0.05），且接近假手术组（P > 0.05）。治疗组肺泡结构损伤及肺出血、水肿情况优于对照组。
外源性肺表面活性物质（PS）可改善重度烧伤 - 冲击复合伤大鼠的氧合，减轻肺水肿及肺毛细血管膜通透性。
