Synthetic lung surfactant reduces alveolar-capillary protein leakage in surfactant-deficient rabbits.
Synthetic lung surfactant reduces alveolar-capillary protein leakage in surfactant-deficient rabbits.
复制标题
DOI：
10.3109/01902148.2015.1024354
复制
发表时间：
2015-06
影响因子：
1.7
通讯作者：
Walther FJ
中科院分区：
文献类型：
--
作者：
Gupta R;Hernández-Juviel JM;Waring AJ;Walther FJ
蛋白质液体的肺泡毛细血管渗漏会损害肺泡通气和表面活性剂功能，并降低急性肺损伤时的肺顺应性。我们研究了用各种临床和合成肺表面活性剂制剂治疗的通气、灌洗表面活性剂缺乏的兔子的肺功能和支气管肺泡灌洗液（BALF）中总蛋白水平之间的相关性。对 109 只通气的年轻成年新西兰白兔进行肺灌洗以诱导表面活性剂缺乏（100% O2 中 PaO2 <100 托），用临床表面活性剂或含有表面活性剂蛋白 B (SP-B) 和/或表面活性剂蛋白 C (SP-C) 类似物的合成表面活性剂制剂治疗，并机械通气 120 分钟。死后 BALF 中的总蛋白水平与表面活性剂处理后 120 分钟的动脉 PO2 和动态肺顺应性值相关。反复肺灌洗使平均 PaO2 值从 540 托降低至 58 托，肺顺应性从 0.64 mL/kg/cm H2O 降低至 0.33 mL/kg/cm H2O。表面活性剂治疗和机械通气后两小时，平均 PaO2 值增至 346 托，肺顺应性增至 0.44 mL/kg/cm H2O。 86 只兔子 (79%) 对表面活性剂治疗有反应，PaO2 增加至 >200 托。十四名无反应者接受了无活性的表面活性剂制剂。 BALF蛋白水平与PaO2和肺顺应性呈负相关(P<0.001)。含有 SP-B 和 SP-C 蛋白质或肽类似物的表面活性剂制剂优于单一蛋白质/肽制剂。临床和合成表面活性剂疗法可减少缺乏表面活性剂的兔子的肺泡毛细血管蛋白质渗漏。同时含有 SP-B 和 SP-C（类似物）的表面活性剂制剂比单独含有 SP-B 或 SP-C 的制剂更有效。
Alveolar-capillary leakage of proteinaceous fluid impairs alveolar ventilation and surfactant function and decreases lung compliance in acute lung injury. We investigated the correlation between lung function and total protein levels in bronchoalveolar lavage fluid (BALF) of ventilated, lavaged surfactant-deficient rabbits treated with various clinical and synthetic lung surfactant preparations. 109 Ventilated, young adult New Zealand White rabbits underwent lung lavage to induce surfactant-deficiency (PaO2 <100 torr in 100% O2), were treated with a clinical surfactant or a synthetic surfactant preparation with surfactant protein B (SP-B) and/or surfactant protein C (SP-C) analogs, and mechanically ventilated for 120 min. Total protein levels in postmortem BALF were correlated with arterial PO2 and dynamic lung compliance values at 120 min post-surfactant treatment. Repeated lung lavages decreased mean PaO2 values from 540 to 58 torr and lung compliance from 0.64 to 0.33 mL/kg/cm H2O. Two hours after surfactant therapy and mechanical ventilation, mean PaO2 values had increased to 346 torr and lung compliance to 0.44 mL/kg/cm H2O. Eighty-six rabbits (79%) responded to surfactant therapy with an increase in PaO2 to values >200 torr. Fourteen non-responders received inactive surfactant preparations. BALF protein levels were inversely correlated with PaO2 and lung compliance (P<0.001). Surfactant preparations containing both SP-B and SP-C proteins or peptide analogs outperformed single protein/peptide preparations. Clinical and synthetic surfactant therapy reduces alveolar-capillary protein leakage in surfactant-deficient rabbits. Surfactant preparations with both SP-B and SP-C (analogs) were more efficient than preparations with SP-B or SP-C alone.