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探讨联合应用吸入一氧化氮（ＩＮＯ）和肺表面活性物质（ＰＳ）对实验性急性呼吸窘迫综合征（ＡＲＤＳ）的治疗作用。方法油酸诱发新西兰兔ＡＲＤＳ模型后，分组（ｎ＝９）进行机械通气治疗６ｈ：（１）对照组；（２）ＮＯ组（２０×１０－６）；（３）ＰＳ组（１００ｍｇ／ｋｇ）；（４）ＰＳ＋ＩＮＯ组（ＰＳＮＯ组）。于基础状态、治疗前和治疗后测定动态胸肺总顺应性（Ｃｄｙｎ）、ＰａＯ２／ＦｉＯ２、肺内静动脉分流Ｑｓ／Ｑｔ）。实验结束时测定肺灌洗液总磷脂（ＴＰＬ）、最小表面张力（γｍｉｎ），肺湿干重比（Ｗ／Ｄ）和肺泡扩张度（Ｖｖ）。结果治疗后对照组肺功能呈下降趋势，ＮＯ组Ｃｄｙｎ无变化，ＰＳ组Ｃｄｙｎ显著增加，ＮＯ组和ＰＳ组ＰａＯ２／ＦｉＯ２和Ｑｓ／Ｑｔ均较对照组明显改善（Ｐ＜０．０５），ＰＳＮＯ组Ｃｄｙｎ变化与ＰＳ组相近，但ＰａＯ２／ＦｉＯ２较ＮＯ组和ＰＳ组进一步增加（Ｐ＜０．０５），Ｑｓ／Ｑｔ进一步降低（Ｐ＜０．０５）。与对照组和ＮＯ组比较，ＰＳＮＯ组和ＰＳ组ＴＰＬ和Ｖｖ明显增加（Ｐ＜０．０１），γｍｉｎ和Ｗ／Ｄ显著降低（Ｐ＜０．０５）。结论联合应用ＩＮＯ和ＰＳ对于实验性ＡＲＤＳ具有协同治疗效果。
To investigate the therapeutic effect of combined inhalation of nitric oxide (INO) and pulmonary surfactant (PS) on experimental acute respiratory distress syndrome (ARDS). Methods After oleic acid induced ARDS model in New Zealand rabbits, the rats in group A (n = 9) were treated with mechanical ventilation for 6 hours: (1) control group; (2) NO group (20 × 10-6); (3) PS group ); (4) PS + INO group (PSNO group). Dynamic global chest compliance (Cdyn), PaO2 / FiO2, and intrapulmonary venous shunt Qs / Qt were measured at baseline, before and after treatment. Pulmonary lavage fluid total phospholipid (TPL), minimum surface tension (γmin), wet / dry lung weight ratio (W / D) and alveolar expansion (Vv) were measured at the end of the experiment. Results After treatment, the lung function of the control group showed a decreasing trend. There was no change of Cdyn in NO group and Cdyn in PS group (P <0.05). The PaO2 / FiO2 and Qs / Qt in NO group and PS group were significantly higher than those in control group The change of Cdyn group was similar to that of PS group, but PaO2 / FiO2 increased further (P <0.05) and Qs / Qt (P <0.05) compared with NO group and PS group. Compared with control group and NO group, TPL and Vv in PSNO group and PS group were significantly increased (P <0.01), while γmin and W / D were significantly decreased (P <0.05). Conclusion The combination of INO and PS has synergistic effect on experimental ARDS.