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应用兔体外循环(CPB)模型,研究CPB中使用大剂量糖皮质激素(GC)对血浆磷脂酶A_2(PLA_2)、肺血管外含水量(EVLW)和肺病理的作用。结果显示:CPB期间血浆PLA_2活性显著增高,CPB 90 min后EVLW显著升高并与血浆PLA_2活性的变化呈正相关(r=0.8439,P<0.01),肺有局灶性不张和间质水肿。CPB开始前5 min预先静注琥珀酸钠氢化可的松20 mg/kg能显著减轻上述改变。提示CPB中大剂量GC的抗炎作用与抑制血浆PLA_2活性有关。
The effects of high dose glucocorticosteroid (GC) on plasma PLA2, extravascular extravascular volume (EVLW) and pulmonary pathology were studied using a rabbit model of cardiopulmonary bypass (CPB). The results showed that plasma PLA 2 activity was significantly increased during CPB, and EVLW was significantly increased 90 min after CPB and positively correlated with plasma PLA 2 activity (r = 0.8439, P <0.01). There was focal atelectasis and interstitial edema in lungs. Pre-infusion of sodium succinate 20 mg / kg succinate 5 min before CPB significantly reduced the above changes. It is suggested that the anti-inflammatory effect of high-dose GC in CPB is related to the inhibition of plasma PLA 2 activity.