Surfactant supplement for adult respiratory distress

用于成人呼吸窘迫的表面活性剂补充剂

基本信息

批准号：
02454352
负责人：
KOBAYASHI Tsutomu
金额：
$ 4.35万
依托单位：
Kanazawa University
依托单位国家：
日本
项目类别：
Grant-in-Aid for General Scientific Research (B)
财政年份：
1990
资助国家：
日本
起止时间：
1990 至 1992
项目状态：
已结题

项目摘要

Pathological process of adult respiratory distress syndrome (ARDS) is largely unknown with 50-70% mortality.(1) Investigation on the pathological process: An exogenous surfactant was mixed with lung edema fluid sampled from ARDS patients, and administered to the lungs of immature newborn rabbits. When the edema fluid protein-to-surfactant ratio increased from 5.6 to 11.2, the dynamic lung compliance of the animals decreased from 1.08 (mean) to 0.43 ml/cmH_2O/kg (P < 0.05). We conclude that a cause of respiratory failure in ARDS is inactivation of pulmonary surfactant by lung edema that appears during the course.(2) Treatment of ARDS by surfactant supplement: Respiratory failure induced by administration of E. Coli endotoxin in rats was largely reversed by supplementation of an exogenous surfactant (100 mg/kg); PaO_2 improved from 106 mmHg (mean) to above 400 mmHg (P < 0.05), and diffuse infiltrates in the chest radiogram disappeared. We conclude that surfactant supplementation can reverse the respiratory failure in ARDS.(3) Artificial surfactant for the supplement therapy: Dipalmitoyl lecithin, unsaturated lecithin (u-L), phosphatidylglycerol and the hydrophobic proteins of porcine surfactant were mixed with various ratios. Dynamic lung compliance of the immature newborn rabbits receiving the mixture consists of all the components was 1.24 ml/cmH_2O/kg (mean), but the value receiving the mixture without u-L was 0.79 ml/cmH_2O/kg (P < 0.05). We conclude that u-L is an important factor for surfactant activity.

成人呼吸窘迫综合征（ARDS）的病理过程很大程度上未知，死亡率为50-70%。（1）病理过程研究：将外源性表面活性剂与ARDS患者采集的肺水肿液混合，给予未成熟的肺刚出生的兔子。当水肿液中蛋白质与表面活性剂的比例从5.6增加到11.2时，动物的动态肺顺应性从1.08（平均值）下降到0.43 ml/cmH_2O/kg（P < 0.05）。我们得出结论，ARDS呼吸衰竭的原因是病程中出现的肺水肿导致肺表面活性物质失活。(2)通过补充表面活性剂治疗ARDS：给予大肠杆菌内毒素引起的大鼠呼吸衰竭在很大程度上得到逆转补充外源性表面活性剂（100毫克/千克）； PaO_2 从 106 mmHg（平均）改善至 400 mmHg 以上（P < 0.05），胸部 X 线片中的弥漫性浸润消失。我们的结论是补充表面活性剂可以逆转ARDS呼吸衰竭。(3)用于补充治疗的人工表面活性剂：二棕榈酰卵磷脂、不饱和卵磷脂(u-L)、磷脂酰甘油和猪表面活性剂的疏水蛋白以不同比例混合。接受所有组分的混合物的未成熟新生兔的动态肺顺应性为1.24ml/cmH_2O/kg(平均值)，而接受不含u-L的混合物的值为0.79ml/cmH_2O/kg(P < 0.05)。我们得出结论，u-L 是表面活性剂活性的重要因素。