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肺顺应性降低是肺氧损伤的早期指标。

Decreased pulmonary compliance is an early indicator of pulmonary oxygen injury.

作者信息

Arkovitz M S, Garcia V F, Szabó C, McConnell K, Bove K, Wispé J R

机构信息

Division of Surgery, Children's Hospital Medical Center, Cincinnati, Ohio 45229, USA.

出版信息

J Surg Res. 1997 Feb 1;67(2):193-8. doi: 10.1006/jsre.1996.4980.

Abstract

Pulmonary oxygen injury is classified by the development of tissue and alveolar edema, surfactant dysfunction, lung inflammation, and decreased pulmonary compliance. In neonates prolonged oxygen therapy is associated with the development of bronchopulmonary dysplasia. Recombinant DNA technology makes it possible to experimentally explore the role of specific proteins in the development of pulmonary oxygen injury. However, in vivo experiments require sensitive ways of identifying pulmonary oxygen injury early in its development. We therefore compared the sensitivities of several experimental assays used to assess pulmonary injury. We found that changes in pulmonary compliance were the most sensitive and showed significant differences after 72 hr of exposure to normobaric hyperoxia (FiO2 = 0.95), which correlated with a small change in the histology of the mice lungs. The concentration of protein in the bronchoalveolar lavage fluid was less sensitive and did not differ significantly until after 96 hr of exposure. The survival in hyperoxia also did not worsen until after 96 hr. The lung wet/ dry weight ratios was the least sensitive assay and did not increase until after 5 days of exposure to normobaric hyperoxia. We conclude that a decrease in pulmonary compliance is an early indicator of pulmonary oxygen injury and may be a better way to study the mechanisms and mediators of pulmonary oxygen injury.

摘要

肺氧损伤根据组织和肺泡水肿、表面活性剂功能障碍、肺部炎症以及肺顺应性降低的发展情况进行分类。在新生儿中,长时间的氧疗与支气管肺发育不良的发生有关。重组DNA技术使实验性探索特定蛋白质在肺氧损伤发展中的作用成为可能。然而,体内实验需要在肺氧损伤发展早期就有敏感的方法来识别它。因此,我们比较了几种用于评估肺损伤的实验检测方法的敏感性。我们发现,肺顺应性的变化最为敏感,在暴露于常压高氧(FiO2 = 0.95)72小时后就显示出显著差异,这与小鼠肺组织学的微小变化相关。支气管肺泡灌洗液中的蛋白质浓度较不敏感,直到暴露96小时后才出现显著差异。高氧环境下的存活率直到96小时后才恶化。肺湿/干重比是最不敏感的检测方法,直到暴露于常压高氧5天后才升高。我们得出结论,肺顺应性降低是肺氧损伤的早期指标,可能是研究肺氧损伤机制和介质的更好方法。

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