Sun B, Curstedt T, Robertson B
Department of Pediatrics, St Göran's Hospital, Stockholm, Sweden.
Acta Paediatr. 1993 Feb;82(2):182-9. doi: 10.1111/j.1651-2227.1993.tb12635.x.
Human meconium components were separated into a water-methanol soluble phase containing mainly proteins and bilirubin and a chloroform soluble phase containing free fatty acids, triglycerides and cholesterol. Various amounts of original meconium, the water-methanol soluble fraction or the chloroform soluble fraction were added to standard suspensions of porcine surfactant (Curosurf). In a pulsating-bubble or Wilhelmy-balance system, meconium and its subfractions inhibited surfactant activity, but the chloroform soluble fraction had the highest specific inhibitory activity. Original meconium in saline (130 or 65 mg/ml) was instilled into the airways of ventilated near-term newborn rabbits (dose 6 ml/kg). Lung-thorax compliance was reduced by 38% in animals aspirating the higher dose and by 27% in the low-dose group. Histological sections showed intra-alveolar accumulation of fine meconium particles in experimental animals, but no plugging of larger airways. We conclude that respiratory failure from meconium aspiration may be mediated, in part, by inactivation of surfactant.
人类胎粪成分被分离为一个主要包含蛋白质和胆红素的水 - 甲醇可溶相，以及一个包含游离脂肪酸、甘油三酯和胆固醇的氯仿可溶相。将不同量的原始胎粪、水 - 甲醇可溶部分或氯仿可溶部分添加到猪表面活性剂（珂立苏）的标准悬浮液中。在脉动气泡或Wilhelmy天平系统中，胎粪及其亚组分抑制表面活性剂活性，但氯仿可溶部分具有最高的特异性抑制活性。将生理盐水（130或65mg/ml）中的原始胎粪滴入通气的近足月新生兔气道（剂量6ml/kg）。吸入高剂量胎粪的动物肺 - 胸顺应性降低38%，低剂量组降低27%。组织学切片显示实验动物肺泡内有细小胎粪颗粒积聚，但较大气道无堵塞。我们得出结论，胎粪吸入导致的呼吸衰竭可能部分是由表面活性剂失活介导的。
