• 作者： 沈建業; 徐剛; 汪大衛; 高尚志
• 作者服務機構： 國防醫學院內科學科及三軍總醫院胸腔內科
• 中文摘要： 我們將狗麻醉以研究中性白血球激活後對側枝通氣及週邊肺反應性的影響。首先將支氣管鏡置於肺小葉呼吸道，崁塞以下之部分則因此而靠側枝系統來通氣。經由雙腔導管，一孔輸入5％二氧化碳及空氣，另一孔則測定壓力。當呼氣至功能肺餘量時，關閉呼吸機，停止呼吸動作。經由側氣系統測求氣流阻力。以組織胺作挑戰試驗，呼吸道阻力以週邊肺反應作為計算標準。靜脈注射PMA後，對組織胺之反應呈明顯的上升。而後，即使沒有組織胺刺激，反應性仍舊上升。這可能是因為PMA激活中性白血球造成肺水腫之故。另一組則先行使用nitrogen mustard，待白血球低於1000/cu. mm.時，再重複前述試驗，結果週邊肺反應性並不增加。我們的結果認為中性白血球激活後釋放氧基或花生油酸代謝產物，不僅會造成週邊肺反應性的增加，也會造成肺水腫。
• 英文摘要： We studied the effects of neutrophil activation on collateral ventilation and peripheral lung reactivityin anesthetized dogs. A fiberoptic bronchoscope was wedged into a segmental airway under direct vision.Ventilation beyond the obstruction thus occurred only through collateral channels. Through one lumen ofa double-lumen catheter threaded through the suction port of a bronchoscope, 5％ (方程式無法摘錄) in air was infusedat a known constant rate (V coll). Through the other lumen, pressure at the tip of the bronchoscope wasmonitored (Pb). For measurements of resistance to flow through the collateral system (Rcs), the ventila-tion was stopped at functional residual capacity (FRC). Histamine was delivered through the bronchoscopeto the obstructed lung segment in the form of an aerosol mist generated by an ultrasonic nebulizer. Mea-surements of Rcs were used as a parameter of the peripheral lung reactivity to histamine challenge. Withinone hour after intravenous infusion of phorbol myristate acetate (PMA), a neutrophil activator, the reac-tivity to histamine significantly increased. After this, Rcs increased even without histamine challenge. Thisincrease may have been due to an edematous injury of lung caused by PMA. The nature of the injury wasconfirmed by wet to dry weight ratios. In the other group, the white cell count dropped below 1000 percu. mm. after intravenous infusion of nitrogen mustard. The same experimental protocols were followed.The Rcs did not increase even with histamine challenge. Our results suggested that substances such as oxy-gen radicals and arachidonic acid metabolites, which can be released by activated neutrophils, may not notonly increase peripheral lung reactivity, but may also induce pulmonary edema.
• 中文關鍵字： neutrophil; collateral ventilation; peripheral lung reactivity
• 英文關鍵字： --