Milani Júnior R, Pereira P M, Dolhnikoff M, Saldiva P H, Martins M A
Departamento de Patologia, Faculdade de Medicina da Universidade de São Paulo, Brazil.
Crit Care Med. 1995 Nov;23(11):1882-9. doi: 10.1097/00003246-199511000-00015.
To develop and study an experimental model for severe pancreatitis-associated lung injury.
Prospective, randomized, controlled trial.
University pulmonary laboratory.
Seventy-eight male Wistar rats.
Pancreatitis was induced by taurocholate injection into the pancreatic duct. Data were compared with data from sham-operated animals.
Pulmonary mechanical measurements were performed in anesthetized and mechanically ventilated rats. Alveolar pressure was obtained by the alveolar capsule technique. Lungs were fixed at functional residual capacity by immersion in liquid nitrogen and were submitted to morphometric studies. Dynamic pulmonary elastance was found to be increased in the acute pancreatitis group (2.25 +/- 0.21 vs. 1.62 +/- 0.10 cm H2O/mL [p < .05]). Morphometric signs of distal airway contraction and vasoconstriction were observed. Increased intraalveolar edema rate (55.6 +/- 12.7% vs. 22.6 +/- 9.6% [p < .001]) was detected in the animals with acute pancreatitis. A high degree of pulmonary unevenness and polymorphonuclear infiltration were also detected in the lungs of the acute pancreatitis animals.
In this severe pancreatitis-associated lung injury model, the mechanical and morphologic alterations were similar to those alterations observed in the adult respiratory distress syndrome. This model may prove to be a useful tool to investigate mechanisms and mediators of the respiratory failure induced by acute pancreatitis and other forms of adult respiratory distress syndrome.
建立并研究重症胰腺炎相关性肺损伤的实验模型。
前瞻性、随机、对照试验。
大学肺部实验室。
78只雄性Wistar大鼠。
通过向胰管内注射牛磺胆酸盐诱导胰腺炎。将数据与假手术动物的数据进行比较。
在麻醉并机械通气的大鼠身上进行肺力学测量。采用肺泡囊技术获取肺泡压力。将肺在功能残气量状态下浸入液氮固定,然后进行形态学研究。发现急性胰腺炎组的动态肺弹性增加(2.25±0.21 vs. 1.62±0.10 cm H2O/mL [p <.05])。观察到远端气道收缩和血管收缩的形态学征象。在急性胰腺炎动物中检测到肺泡内水肿率增加(55.6±12.7% vs. 22.6±9.6% [p <.001])。在急性胰腺炎动物的肺中还检测到高度的肺不均匀性和多形核白细胞浸润。
在这个重症胰腺炎相关性肺损伤模型中,机械和形态学改变与成人呼吸窘迫综合征中观察到的改变相似。该模型可能被证明是研究急性胰腺炎及其他形式成人呼吸窘迫综合征所致呼吸衰竭的机制和介质的有用工具。