Nieman G F, Bredenberg C E, Clark W R, West N R
J Appl Physiol Respir Environ Exerc Physiol. 1981 Oct;51(4):895-904. doi: 10.1152/jappl.1981.51.4.895.
In vivo cinemicroscopic studies of subpleural alveoli were conducted in dogs for 4 h after pulmonary lavage with 5% Tween 20 and after lavage with normal saline. Saline-lavaged alveoli showed little change in alveolar size during tidal ventilation, whereas Tween lavage resulted both in alveolar recruitment and marked variation in alveolar size from end expiration to peak inspiration, with total collapse frequently occurring by end expiration. Following Tween, alveolar stability decreased, but alveolar capillary perfusion increased. Marked recovery of stability by 4 h was noted in most alveoli. Wilhelmy balance studies on lung extracts showed a decrease in surfactant function 30 min after Tween and a partial recovery of surfactant activity after 4 h. This study provides in vivo evidence that normal surfactant function is critical to alveolar stability and that alveolar stability is markedly restored 4 h after acute deactivation or displacement by Tween. Surfactant deactivation and loss of alveolar stability are associated with increased alveolar capillary perfusion creating significant ventilation-perfusion ratio abnormalities.
在用5%吐温20进行肺灌洗后以及用生理盐水灌洗后，对犬的胸膜下肺泡进行了4小时的体内电影显微镜研究。用生理盐水灌洗的肺泡在潮式通气期间肺泡大小变化很小，而吐温灌洗导致肺泡复张以及从呼气末到吸气峰值期间肺泡大小有显著变化，呼气末时常出现完全塌陷。吐温灌洗后，肺泡稳定性下降，但肺泡毛细血管灌注增加。大多数肺泡在4小时时稳定性显著恢复。对肺提取物进行的威廉米天平研究显示，吐温处理30分钟后表面活性剂功能下降，4小时后表面活性剂活性部分恢复。本研究提供了体内证据，表明正常的表面活性剂功能对肺泡稳定性至关重要，并且在吐温急性使其失活或置换后4小时，肺泡稳定性显著恢复。表面活性剂失活和肺泡稳定性丧失与肺泡毛细血管灌注增加相关，从而产生显著的通气/灌注比异常。
