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皮质类固醇在食物误吸中的生理作用。

Physiological effects of corticosteroids in foodstuff aspiration.

作者信息

Wynne J W, DeMarco F J, Hood C I

出版信息

Arch Surg. 1981 Jan;116(1):46-9. doi: 10.1001/archsurg.1981.01380130028007.

Abstract

Aspiration of gastric contents that contain small food particles has been shown to cause severe pneumonitis, even when the pH of the aspirate is greater than 2.5. The effects of corticosteroids on the hemodynamic and ventilatory consequences of this type of aspiration have not been investigated. Twenty healthy mongrel dogs were anesthetized and 2 mL/kg of gastric contents (pH 5.9) that contained small food particles were injected into their tracheas. Group 1 animals (controls, N = 10) received no therapy. Group 2 animals (steroid-treated, N = 10) were given methylprednisolone intravenously, 30 mg/kg, three times a day beginning one hour after aspiration. The animals were observed for 14 days, during which time there were no statistically significant differences between the groups in mortality, PaCO2, pH, systemic and pulmonary arterial blood pressures, fractional intrapulmonary shunt, or histological findings. Arterial PO2 was lower at 24 hours in group 2 dogs than in group 1 dogs. We conclude that steroids are of no benefit in the treatment of foodstuff-induced aspiration pneumonia.

摘要

含有小食物颗粒的胃内容物误吸已被证明可导致严重的肺炎,即使误吸物的pH值大于2.5。皮质类固醇对这类误吸的血流动力学和通气后果的影响尚未得到研究。将20只健康的杂种狗麻醉后,将2 mL/kg含有小食物颗粒的胃内容物(pH 5.9)注入它们的气管。第1组动物(对照组,N = 10)未接受治疗。第2组动物(类固醇治疗组,N = 10)在误吸后1小时开始,每天静脉注射甲泼尼龙30 mg/kg,共3次。对动物观察14天,在此期间,两组在死亡率、PaCO2、pH值、体循环和肺动脉血压、肺内分流分数或组织学结果方面无统计学显著差异。第2组狗在24小时时的动脉血氧分压低于第1组狗。我们得出结论,类固醇对食物诱导的吸入性肺炎治疗无效。

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