Effects of maternal treatment with corticosteroids, T3, TRH, and their combinations on lung function of ventilated preterm rabbits with and without surfactant treatments.
Effects of maternal treatment with corticosteroids, T3, TRH, and their combinations on lung function of ventilated preterm rabbits with and without surfactant treatments.
复制标题
母体用皮质类固醇、T3、TRH 及其组合治疗对有和没有表面活性剂治疗的通气早产兔肺功能的影响。
DOI：
10.1164/ajrccm/136.4.892
复制
发表时间：
1987
期刊：
影响因子：
--
通讯作者：
Ruffini,L
中科院分区：
文献类型：
--
作者：
Ikegami,M;Jobe,AH;Pettenazzo,A;Seidner,SR;Berry,DD;Ruffini,L
怀孕的DOS接受倍他米松、T3、TRH或倍他米松加T3或TRH的组合治疗，剂量为已知的影响肺成熟的每种药物。早产兔在胎龄27天时出生，每组一半接受表面活性物质TA治疗，并在呼吸机-体积计系统中进行呼吸，使潮气量调节到12~13ml/kg的平均值。在30分钟时，当研究组的平均二氧化碳分压在33到42毫米汞柱之间时，通过达到所需潮气量所需的最大吸气压、顺应性和通风效率指数来评估每只兔子的肺功能。肺功能的测量显示，在没有表面活性物质的情况下，皮质类固醇或T3没有好处，而TRH显著改善了肺功能。虽然表面活性物质治疗改善了所有组的肺功能，但在单一激素治疗后效果最好的是皮质类固醇。在表面活性物质治疗的动物中，皮质类固醇激素和TRH的联合使用导致了最好的总体反应。用放射性标记的白蛋白测量进入和流出肺的蛋白质的渗漏。在所有组中，随着最大通气压的降低，渗漏减少，并且在所有组中使用表面活性物质治疗后，渗漏减少。与单独使用皮质类固醇对呼吸压力的影响相比，皮质类固醇减少进入呼吸道的蛋白质泄漏的作用更大(p<；0.01)。在对照组动物中，没有一种激素处理显著增加饱和磷脂酰胆碱池的大小。皮质类固醇和促肾上腺皮质激素释放激素使早产儿的肺在表面活性物质治疗后有了很大的功能改善。综上所述，这些结果与早产儿肺结构对外源性激素的反应一致。
Pregnant does went treated with betamethasone, T3, TRH, or combinations of betamethasone plus T3or TRH using doses of each agent known to effect lung maturation. Preterm rabbits went then delivered at 27 days gestational age, half of each group was treated with Surfactant TA, and the rabbits went ventilated In a ventilator-plethysmograph system such that tidal volumes went regulated to mean values of 12 to 13 ml/kg. At 30 min of age when mean PCO2values for the study groups went between 33 and 42 mm Hg, lung function of each rabbit was evaluated by the peak inspiratory pressure needed to achieve the desired tidal volume, by compliance, and by the ventilation efficiency index. The measures of lung function showed no benefit of corticosteroids or T3in the absence of surfactant, whereas TRH significantly improved lung function. Although surfactant treatment improved lung function in all groups, the best effect after a single hormone treatment was with corticosteroid. The combined use of corticosteroids and TRH In surfactant-treated animals resulted in the best overall responses. The leak of protein into and out of the lungs was measured with radiolabeled albumins. The leak decreased as peak ventilatory pressures decreased in all groups and decreased with surfactant treatments of all groups. Corticosteroids decreased the protein leak into the airways more than could be accounted for by the effects of corticosteroids on ventilatory pressures alone (p < 0.01). None of the hormone treatments significantly increased the saturated phosphatidylcholine pool sizes from the low values noted in the control animals. Corticosteroids and TRH “prepared” the preterm lung to have a large functional improvement after a surfactant treatment. Taken together, these results are consistent with changes in preterm lung structure in response to exogenous hormones.