Department of Anesthesiology, The Second Affiliated Hospital of Harbin Medical University, Harbin, Heilongjiang Province, China.
Department of Intensive Care Unit, The Cancer Hospital of Harbin Medical University, Harbin, Heilongjiang Province, China.
Arch Med Res. 2016 May;47(4):275-84. doi: 10.1016/j.arcmed.2016.07.012.
Patients with acute respiratory distress syndrome (ARDS) are particularly susceptible to ventilator-induced lung injury (VILI). This study investigated the effect of budesonide on VILI in a rat model of inflammatory ARDS.
Forty eight rats were randomized into three groups (n = 16 each): sham group (S), endotoxin/ventilation group (LV), endotoxin/ventilation/budesonide group (LVB). Rats in the S group received anesthesia only. Rats in the LV and LVB groups received endotoxin to simulate ARDS and were mechanically ventilated for 4 h (tidal volume 30 mL/kg). Rats in the LVB group received budesonide 1 mg, and rats in the LV group received saline in airway. PaO2/FiO2, lung wet-to-dry weight ratios, inflammatory factors in serum and bronchoalveolar lavage fluid (BALF), histopathologic analysis of lung tissue, and survival were examined.
PaO2/FiO2 was significantly increased in rats in the LVB group compared to the LV group. Total cell count, macrophages, and neutrophils in BALF, and levels of intercellular adhesion molecule (ICAM)-1, tumor necrosis factor (TNF)-α, interleukin (IL)-1β, and IL-8 in BALF and serum were significantly decreased in rats in the LVB group compared to the LV group, whereas levels of IL-10 in BALF and serum were significantly increased. Histopathological changes of lung injury and apoptosis were reduced, and survival was increased in rats in the LVB group compared to the LV group.
Budesonide ameliorated VILI in a rat model of inflammatory ARDS.
急性呼吸窘迫综合征（ARDS）患者尤其容易发生呼吸机相关性肺损伤（VILI）。本研究旨在探讨布地奈德对炎症性 ARDS 大鼠模型中 VILI 的影响。
48 只大鼠随机分为三组（每组 16 只）：假手术组（S）、内毒素/通气组（LV）、内毒素/通气/布地奈德组（LVB）。S 组仅接受麻醉。LV 和 LVB 组大鼠接受内毒素模拟 ARDS，并接受机械通气 4 小时（潮气量 30ml/kg）。LVB 组大鼠给予布地奈德 1mg，LV 组大鼠给予气道生理盐水。检测 PaO2/FiO2、肺湿重/干重比、血清和支气管肺泡灌洗液（BALF）中炎症因子、肺组织病理分析和生存率。
与 LV 组相比，LVB 组大鼠 PaO2/FiO2 显著升高。与 LV 组相比，LVB 组大鼠 BALF 中总细胞计数、巨噬细胞和中性粒细胞，BALF 和血清中细胞间黏附分子（ICAM）-1、肿瘤坏死因子（TNF）-α、白细胞介素（IL）-1β和 IL-8 水平显著降低，而 BALF 和血清中 IL-10 水平显著升高。与 LV 组相比，LVB 组大鼠肺损伤和细胞凋亡的组织学变化减轻，生存率提高。
布地奈德可改善炎症性 ARDS 大鼠模型中的 VILI。
