Surfactant alterations in acute inflammatory lung injury from aspiration of acid and gastric particulates
Surfactant alterations in acute inflammatory lung injury from aspiration of acid and gastric particulates
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DOI：
10.1152/ajplung.00229.2004
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发表时间：
2005-04-01
影响因子：
4.9
通讯作者：
Notter, RH
中科院分区：
文献类型：
--
作者：
Davidson, BA;Knight, PR;Notter, RH
本研究检查了因气管内滴注盐酸（ACID，pH 1.25）、未酸化的小胃颗粒（SNAP）或酸和小胃颗粒（CASP）的组合而导致炎症性肺损伤的大鼠的表面活性剂功能障碍。给予 CASP 的大鼠在 6、24 和 48 小时出现最严重的肺损伤，原因是动脉氧合降低，支气管肺泡灌洗 (BAL) 中红细胞、总白细胞、中性粒细胞、总蛋白和白蛋白增加。在所有形式的吸入性损伤中，BAL 中大表面活性剂聚集体的含量均减少，但在给予 CASP 的大鼠中减少幅度最大。与盐水对照相比，吸入性损伤大鼠的大聚集体的磷脂酰胆碱 (PC) 水平也降低，溶血 PC 和总蛋白水平升高（CASP 的异常大于单独的 SNAP 或 ACID）。在吸入损伤的大鼠中，气泡表面活性剂聚集体在 6、24 和 48 小时时降低表面张力的能力受到损害，在给予 CASP 的动物中发现活性降低幅度最大。基于动脉氧合和 BAL 中白蛋白、蛋白质和红细胞水平，表面活性剂功能障碍（最小表面张力增加和大聚集物含量减少）与肺损伤严重程度之间存在很强的统计相关性（P < 0.0001）。表面活性剂功能障碍还与充气和通气过程中肺容量的减少密切相关（P = 0.0004 - 0.005）。这些结果表明，表面活性剂异常在胃吸入性肺损伤中具有重要的功能，并且与单独的 ACID 或 SNAP 相比，CASP 中发现的损伤严重程度增加显着。
This study examines surfactant dysfunction in rats with inflammatory lung injury from intratracheal instillation of hydrochloric acid ( ACID, pH 1.25), small nonacidified gastric particles ( SNAP), or combined acid and small gastric particles ( CASP). Rats given CASP had the most severe lung injury at 6, 24, and 48 h based on decreases in arterial oxygenation and increases in erythrocytes, total leukocytes, neutrophils, total protein, and albumin in bronchoalveolar lavage (BAL). The content of large surfactant aggregates in BAL was reduced in all forms of aspiration injury, but decreases were greatest in rats given CASP. Large aggregates from aspiration-injured rats also had decreased levels of phosphatidylcholine ( PC) and increased levels of lyso-PC and total protein compared with saline controls ( abnormalities for CASP were greater than for SNAP or ACID alone). The surface tension-lowering ability of large surfactant aggregates on a bubble surfactometer was impaired in rats with aspiration injury at 6, 24, and 48 h, with the largest activity reductions found in animals given CASP. There were strong statistical correlations between surfactant dysfunction ( increased minimum surface tension and reduced large aggregate content) and the severity of lung injury based on arterial oxygenation and levels of albumin, protein, and erythrocytes in BAL ( P < 0.0001). Surfactant dysfunction also correlated strongly with reduced lung volumes during inflation and deflation ( P = 0.0004 - 0.005). These results indicate that surfactant abnormalities are functionally important in gastric aspiration lung injury and contribute significantly to the increased severity of injury found in CASP compared with ACID or SNAP alone.