Goldman G, Welbourn R, Klausner J M, Kobzik L, Valeri C R, Shepro D, Hechtman H B
Department of Surgery, Brigham and Women's Hospital, Boston, MA 02115.
Surgery. 1993 Jul;114(1):13-20.
Acid aspiration leads to lung injury characterized by polymorphonuclear neutrophil leukocytes (PMN) sequestration and edema. This study investigates whether localized acid aspiration leads to activation of circulating PMN and triggers both local and remote PMN sequestration and whether these cells are responsible for increase in pulmonary permeability and systemic organ edema.
Rats pretreated with intravenous saline solution or rendered neutropenic (nitrogen mustard or antineutrophil serum) underwent tracheostomy and insertion of a cannula into a lung segment. This was followed by instillation of either 0.1 N HCl or saline solution.
After 30 minutes leukopenia was noted (2650 white blood cells/mm3) in saline-treated, acid-lavaged rats, and circulating PMN produced H2O2 (20 femtomole dichlorofluorescein/PMN compared with 3 femtomole in control animals (both, p < 0.05). PMN were progressively sequestered in the nonaspirated lung, the heart, and kidney. Permeability and edema developed in the lungs and systemic organs. In neutropenic rats there was a reduction of aspiration-induced thromboxane B2 and leukotriene B4 synthesis (p < 0.05), decrease in lung wet to dry weight and protein level in bronchoalveolar lavage of the aspirated and nonaspirated lungs, and reduction in myeloperoxidase activity in the heart and kidney and in wet to dry weight of these organs (all, p < 0.05).
These data indicate that localized acid aspiration activates circulating neutrophils and promotes their sequestration in the lungs and systemic organs. These cells are largely responsible for the multisystem organ edema.
酸误吸可导致以多形核中性粒细胞（PMN）滞留和肺水肿为特征的肺损伤。本研究旨在探讨局部酸误吸是否会导致循环中的PMN活化，并引发局部和远处的PMN滞留，以及这些细胞是否会导致肺通透性增加和全身器官水肿。
用静脉生理盐水预处理或造成中性粒细胞减少（用氮芥或抗中性粒细胞血清）的大鼠接受气管切开术，并将套管插入肺段。随后分别滴注0.1N盐酸或生理盐水。
30分钟后，经生理盐水处理、酸灌洗的大鼠出现白细胞减少（白细胞计数为2650/mm³），循环中的PMN产生过氧化氢（20飞摩尔二氯荧光素/PMN，而对照动物为3飞摩尔，两者均p<0.05）。PMN逐渐滞留在未误吸的肺、心脏和肾脏中。肺和全身器官出现通透性增加和水肿。在中性粒细胞减少的大鼠中，误吸诱导的血栓素B2和白三烯B4合成减少（p<0.05），误吸和未误吸肺的支气管肺泡灌洗中肺湿重与干重及蛋白水平降低，心脏和肾脏的髓过氧化物酶活性及这些器官的湿重与干重降低（所有均p<0.05）。
这些数据表明，局部酸误吸可激活循环中的中性粒细胞，并促进其在肺和全身器官中的滞留。这些细胞在很大程度上导致了多系统器官水肿。
