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[体外膜肺氧合(ECMO)与前列环素衍生物治疗严重呼吸衰竭的有效性实验研究]

[Experimental study of the effectiveness of ECMO (extracorporeal membrane oxygenation) and PGI2 derivative against severe respiratory failure].

作者信息

Ishibashi Y

机构信息

Second Department of Surgery, Hokkaido University School of Medicine, Sapporo, Japan.

出版信息

Hokkaido Igaku Zasshi. 1993 Jan;68(1):65-77.

PMID:8444405
Abstract

Severe respiratory failure was made on twenty dogs with intratracheal administration of the linoleic acid to study the effectiveness of ECMO. The dogs were divided into four groups: First group (GI); respiratory failure, second group (G II); respiratory failure with pumpless A-V bypass, third group (G III); respiratory failure with V-A bypass, fourth group (G IV); respiratory failure with V-A bypass and administration of OP-41483 (PGI2 derivative). The effectiveness of ECMO was studied with different concentration of Prostaglandin I2 (PGI2) and Thromboxane A2 (TxA2). This experiment showed significant prolongation of mean survival time in dogs of respiratory failure treated with the use of ECMO. In GI and G II, TxB2, metabolic product of TxA2, increased and the ratio of 6-ketoPGF1 alpha, metabolic product of PGI2, versus TxB2, decreased progressively. In G III and G IV, the TxB2 was increased during the first two or three hours after intratracheal administration of linoleic acid and then reached a steady level. In G3, the ratio of 6-ketoPGF1 alpha versus TxB2 was approximately 0.5 after the linoleic acid administration. However, in the case of G IV with combined application of PGI2 derivative, the ratio decreased to 0.59 +/- 0.08 in one or two hours after the administration, then increased progressively and reached a value of 1.04 +/- 0.27 in eight hours after the linoleic acid administration. In conclusion, this study demonstrates that therapeutical effects of ECMO against respiratory failure could be elevated by using PGI2 derivative.

摘要

通过气管内给予亚油酸对20只犬造成严重呼吸衰竭,以研究体外膜肺氧合(ECMO)的有效性。这些犬被分为四组:第一组(GI);呼吸衰竭,第二组(G II);无泵动静脉旁路的呼吸衰竭,第三组(G III);静脉-动脉旁路的呼吸衰竭,第四组(G IV);静脉-动脉旁路并给予OP-41483(前列环素I2衍生物)的呼吸衰竭。使用不同浓度的前列腺素I2(PGI2)和血栓素A2(TxA2)研究ECMO的有效性。该实验表明,使用ECMO治疗的呼吸衰竭犬的平均存活时间显著延长。在GI和G II组中,TxA2的代谢产物TxB2增加,PGI2的代谢产物6-酮前列环素F1α与TxB2的比值逐渐降低。在G III和G IV组中,气管内给予亚油酸后的最初两三个小时内TxB2升高,然后达到稳定水平。在G3组中,给予亚油酸后6-酮前列环素F1α与TxB2的比值约为0.5。然而,在联合应用PGI2衍生物的G IV组中,给药后一两个小时该比值降至0.59±0.08,然后逐渐升高,在给予亚油酸八小时后达到1.04±0.27。总之,本研究表明,使用PGI2衍生物可提高ECMO对呼吸衰竭的治疗效果。

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