Inwood R J, Gora P, Hunt C E
Prostaglandins Med. 1981 May;6(5):503-14. doi: 10.1016/0161-4630(81)90109-9.
Intralipid-related pulmonary alterations have been attributed to hyperlipemia. To better quantitate and explain these alterations, Intralipid (0.4 gm/kg over one hour) was infused into three groups of rabbits and saline into a fourth group. Group I had normal lung function; Groups II-IV were pretreated with oleic acid and Group III also received indomethacin. Serum triglyceride (TG) levels, arterial (a) and end-tidal (A) PCO2 and PO2 were measured at baseline and then hourly for six hours. There was no ventilatory deterioration in Group I despite a peak TG level of 638 mg/dl. In Group II there was an Intralipid-related PaO2 decrease of 11-13 mmHg (p less than .01) and a delta AaPO2 increase of 16 mmHg (p less than .01); both returned to baseline without significant TG normalization. Since indomethacin prevented these PaO2 and delta AaPO2 changes despite a significant TG increase, the effects of Intralipid appear not to be TG-related but rather to be related to PG-mediated alterations in pulmonary vasomotor tone. Our results are most consistent with a net increase in vasodilating prostaglandins and resultant hypoxemia secondary to unblocking of baseline hypoxic vasoconstriction.
脂肪乳剂相关的肺部改变被认为与高脂血症有关。为了更好地量化和解释这些改变，将脂肪乳剂（1小时内输注0.4克/千克）注入三组兔子体内，将生理盐水注入第四组兔子体内。第一组肺功能正常；第二至四组用油酸预处理，第三组还接受了吲哚美辛治疗。在基线时以及随后的6小时内每小时测量血清甘油三酯（TG）水平、动脉血（a）和呼气末（A）二氧化碳分压及氧分压。第一组尽管TG峰值水平达到638毫克/分升，但通气功能并未恶化。在第二组中，与脂肪乳剂相关的动脉血氧分压（PaO2）下降了11 - 13毫米汞柱（p小于0.01），肺泡-动脉血氧分压差（ΔAaPO2）增加了16毫米汞柱（p小于0.01）；两者均恢复至基线水平，而TG并未显著恢复正常。由于尽管TG显著升高，但吲哚美辛可预防这些PaO2和ΔAaPO2的变化，因此脂肪乳剂的作用似乎与TG无关，而是与前列腺素介导的肺血管运动张力改变有关。我们的结果最符合血管舒张性前列腺素的净增加以及因解除基线低氧性血管收缩而导致的继发性低氧血症。
