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目的探讨吸入一氧化氮（NO）对革兰氏阴性杆菌内毒素（LPS）诱发的急性肺损伤（ALI）肺泡毛细血管膜的影响。方法在机械通气条件下观察吸入NO对损伤肺的氧合功能、肺动态顺应性（Cdyn）、气道阻力（Rrs）及支气管－肺泡灌洗液（BAIF）中蛋白含量（TP）、中性白细胞（PMN）记数及肺湿／干重比（W／D）的影响和形态学检查。结果与对照组比较，吸入NO组治疗6h后的氧合指数（PaO2／FiO2）为37．5±1．8kPa比29．2±3．4kPa、肺内分流率（Qs／Qt）为（18．4±0．99）×10－2比（24．10±1．97）×10-2、肺动态顺应性（Cdyn）为6．53±0．31ml／kPa比5．41±0．41ml／kPa，均较求治疗组有显著改善（P＜0．01）。吸入NO组BALF中TP含量显著降低，为84．0±9．0mg／kg比100．9±7．3mg／kg、PMN记数为（13．83±1．125）×106／L比（19．78±1．289）×106／L，肺湿／干重比（W／D）为3．83±0．13比4．37±0．11。形态学示肺内PMN浸润和水肿减轻。结论吸入NO可显著减轻肺泡毛细血管膜的损伤，对ALI的病程有显著的影响。能为综合治疗提供宝贵的时机。
Objective To investigate the effects of inhaled nitric oxide (NO) on alveolar capillary membrane in acute lung injury (ALI) induced by Gram-negative bacilli endotoxin (LPS). Methods The mechanical ventilation was used to observe the effects of inhaled NO on the oxygenation function, lung dynamic compliance (Cdyn), airway resistance (Rrs), and protein content (TP) in bronchoalveolar lavage fluid (BAIF) Leukocyte (PMN) count and lung wet / dry weight ratio (W / D) and morphological examination. Results Compared with the control group, the oxygenation index (PaO2 / FiO2) of 37.5 ± 1.8kPa and 29.2 ± 3.4kPa after 6h inhalation of NO group was significantly higher than that of the control group (Qs / Qt) .4 ± 0.99) × 10-2 (24.10 ± 1.97) × 10-2, and the dynamic compliance of lungs (Cdyn) was 6.53 ± 0.31ml / kPa vs 5.41 ± 0. 41ml / kPa, were significantly improved than the treatment group (P <0.01). The content of TP in BALF of inhaled NO group was significantly lower than that of the control group (84.0 ± 9.0 mg / kg vs 100.9 ± 7.3 mg / kg, PMN count was (13.83 ± 1.125) × 106 / L 19.78 ± 1.289) × 106 / L and lung wet / dry weight ratio (W / D) was 3.83 ± 0.13 vs 4.37 ± 0.11. Morphology showed pulmonary PMN infiltration and edema alleviate. Conclusion NO inhalation can significantly reduce the damage of alveolar capillary membrane and have a significant effect on the course of ALI. Comprehensive treatment can provide valuable time.