不同剂量外源性表面活性剂治疗新生兔胎粪吸入综合征。

Revista do Hospital das Clinicas Pub Date : 2004-06-01 Epub Date: 2004-07-28 DOI:10.1590/s0041-87812004000300003
João Cesar Lyra, Renata S Mascaretti, Alexander Roberto Precioso, Yin Chia Chang, Maria Tereza Zulini da Costa, Flávio Adolfo Costa Vaz, Yassuhiko Okay, Celso Moura Rebello
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摘要

目的:探讨2种不同剂量外源性表面活性剂对新生家兔肺力学及肺实质膨胀规律的影响。方法:新生家兔气管切开术,随机分为4个研究组:对照组气管内不植入任何材料;MEC组灌胃胎粪,不做表面活性剂处理;S100组和S200组小鼠灌胃胎粪,分别用100和200 mg/kg外源表面活性剂(由buantan研究所生产)处理。4组动物在25分钟的时间内进行机械通气。评估动态顺应性、通气压力、潮气量和最大肺容量(P-V曲线)。采用平均线性截距(Lm)进行组织学分析,肺组织畸变指数(SDI)由Lm均值的标准差得出。采用单因素方差分析,a = 0.05。结果:通气25 min后,动态顺应性(mL/cm H2O.kg)为0.87±0.07(对照组);0.49 +/- 0.04 (mec *);0.67 +/- 0.06 (s100);0.67 +/- 0.08 (S200),通气压(cm H2O) 9.0 +/- 0.9(对照组);16.5 +/- 1.7 (mec *);12.4 +/- 1.1 (s100);12.1 +/- 1.5 (S200)。与MEC组相比,两个治疗组的Lm值更低,肺实质的均匀性更强:SDI = 7.5 +/- 1.9(对照组);11.3 +/- 2.5 (mec *), 5.8 +/- 1.9 (s100);6.7 +/- 1.7 (S200)(与其他组比较*P < 0.05)。结论:经表面活性剂处理的大鼠肺力学性能明显改善,肺实质规律性明显增强。使用两种剂量治疗后的结果没有差异。
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Different doses of exogenous surfactant for treatment of meconium aspiration syndrome in newborn rabbits.

Objective: To evaluate the effects of 2 different doses of exogenous surfactant on pulmonary mechanics and on the regularity of pulmonary parenchyma inflation in newborn rabbits.

Method: Newborn rabbits were submitted to tracheostomy and randomized into 4 study groups: the Control group did not receive any material inside the trachea; the MEC group was instilled with meconium, without surfactant treatment; the S100 and S200 groups were instilled with meconium and were treated with 100 and 200 mg/kg of exogenous surfactant (produced by Instituto Butantan) respectively. Animals from the 4 groups were mechanically ventilated during a 25-minute period. Dynamic compliance, ventilatory pressure, tidal volume, and maximum lung volume (P-V curve) were evaluated. Histological analysis was conducted using the mean linear intercept (Lm), and the lung tissue distortion index (SDI) was derived from the standard deviation of the means of the Lm. One-way analysis of variance was used with a = 0.05.

Results: After 25 minutes of ventilation, dynamic compliance (mL/cm H2O.kg) was 0.87 +/- 0.07 (Control); 0.49 +/- 0.04 (MEC*); 0.67 +/- 0.06 (S100); and 0.67 +/- 0.08 (S200), and ventilatory pressure (cm H2O) was 9.0 +/- 0.9 (Control); 16.5 +/- 1.7 (MEC*); 12.4 +/- 1.1 (S100); and 12.1 +/- 1.5 (S200). Both treated groups had lower Lm values and more homogeneity in the lung parenchyma compared to the MEC group: SDI = 7.5 +/- 1.9 (Control); 11.3 +/- 2.5 (MEC*), 5.8 +/- 1.9 (S100); and 6.7 +/- 1.7 (S200) (*P < 0.05 versus all the other groups).

Conclusions: Animals treated with surfactant showed significant improvement in pulmonary mechanics and more regularity of the lung parenchyma in comparison to untreated animals. There was no difference in results after treatment with either of the doses used.

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