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[肺气肿。实验性诱导肺气肿的肺功能变化]

[Pulmonary emphysema. Changes in the pulmonary function of experimentally induced emphysema].

作者信息

Schlick W

出版信息

Fortschr Med. 1977 Mar 3;95(9):583-6.

PMID:844785
Abstract

By intratracheal injection of the protease papain to experimental animals parenchymal changes in the lung can be induced, that resemble human emphysema. Papain (dosage 26 to 112 mg, 1 to 4 injections) was given intratracheally to 8 bastard dogs (weighing from 12.5 to 20 kg) during light general anesthesia. Pulmonary function was assessed in weekly intervals and related to morphologic changes in the lung. Static compliance of the lung and FRC measured during respiratory arrest were increased after papain, bronchial resistance, measured while artifically ventilated at constant pressure was also increased. Changes of static lung compliance and FRC were seen after the first administration of papain, but further increased with time of observation and after multiple doses of papain. Increase of resistance was not found before 5 weeks. At quiet breathing resistance was not increased at all. No significant changes were found of arterial pO2 and pCO2, pH, standard and actual bicarbonate, diffusion capacity for O2, tidal volume, minute ventilation and ventilatory rate. Morphological findings confirmed the changes described by others. Pulmonary function appears to be pathological at a time when morphology still seems to be normal. The question is discussed to what extent the model of experimental emphysema induced by proteolytic enzymes can contribute to the understanding of human pulmonary emphysema. Lung function in the course of experimental emphysema is compared with function in different clinical types of emphysema.

摘要

通过向实验动物气管内注射蛋白酶木瓜蛋白酶,可诱发肺部实质变化,这些变化类似于人类肺气肿。在轻度全身麻醉期间,向8只杂种犬(体重12.5至20千克)气管内注射木瓜蛋白酶(剂量26至112毫克,注射1至4次)。每周评估一次肺功能,并将其与肺部形态学变化相关联。木瓜蛋白酶注射后,呼吸暂停时测得的肺静态顺应性和功能残气量增加,在恒压人工通气时测得的支气管阻力也增加。首次注射木瓜蛋白酶后即可观察到肺静态顺应性和功能残气量的变化,但随着观察时间的延长和多次注射木瓜蛋白酶,这些变化会进一步增加。5周前未发现阻力增加。安静呼吸时阻力根本没有增加。动脉血氧分压、二氧化碳分压、pH值、标准碳酸氢盐和实际碳酸氢盐、氧弥散能力、潮气量、分钟通气量和呼吸频率均未发现明显变化。形态学检查结果证实了其他人所描述的变化。在形态学似乎仍正常时,肺功能似乎已出现病理改变。文中讨论了由蛋白水解酶诱导的实验性肺气肿模型在多大程度上有助于理解人类肺气肿的问题。将实验性肺气肿过程中的肺功能与不同临床类型肺气肿的功能进行了比较。

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