高分子聚合物逆转血浆所致肺表面活性物质失活

摘要

Objective Objective A variety of substances including plasma have been found to affect adversely the surface tension-lowering activity of pulmonary surfactant,and this effect may be important in the pathogenesis of a number of human diseases such as acute lung injury(ALI) and acute respiratory distress syndrome(ARDS).We were aimed at exploring whether inactivation of surfactant induced by plasma could be prevented or reduced by polymers.Methods We measured the maximum(γmax)and minimum sueface tension(γmin) of dextran, polyethylene glycol (PEG), hyaluronan(HA),pulmonary surfactant(Curosur), plasma and their mixtures by captive bubble surfactometer,respectively.Values of stability index(S.I.) were also calculated.Results The γmin of different polymers,plasma and their mixtures were more than 10 mN/m and S. I. of which were less than 0.8.The γmin and S. I. of Curosurf(1.25mg/ ml) were (1.54±0.03)mN/m and 1.71±0.01 ,respectively.The min and S.I.of Curosurf mixed with 1%,2% or 3% plasma were(19.0±0.46)mN/m, (22.9±0.42)mN/m and(22.6±1.22)mN/m and 0.38±0.05,0.34±0.02 and0.39±0.15, respectively. When mixed with 5% PEG, 5% dextran and 0.25% HA, the γmin significantly decreased to[(1.59±0.22)mN/m, (1.43±0.24)mN/m, (17.2±0.72)mN/m; (0.88±0.06) mN/m, (1.18±0.06) mN/m,(1.46±0.22)mN/m and (1.22±0.10)mN/m,(1.33 ～ O.O7 )mN/m, ( l.42 ～ O. 18 )mNIm,mspecfively, ( P 10mN/m,SI<0.8,而curosurf(1.25mg/ml)的γmin为(1.54±0.03)mN/m,SI为1.71±0.01.Curosurf与1%、2%或3%的血浆混合后γmin分别为(19.0±0.46)mN/m、(22.9±0.42)mN/m和(22.6±1.22)mN/m,SI为0.38±0.05、0.34±0.02和0.39±0.15.上述混合物与5%PEG、5%dextran或0.25%HA混合,γmin分别降至(1.59±0.22)mN/m、(1.43±0.24)mN/m、(17.2±0.72)mN/m;(0.88±0.06)mN/m、(1.18±0.06)mN/m、(1.46±0.22)mN/m及(1.22±0.10)mN/m、(1.33±0.07)mN/m、(1.42±0.18)mN/m,与curosurf同各浓度血浆混合物比较,差异均有统计学意义(P均<0.05).SI分别增加到1.72±0.04、1.73±0.04、0.43±0.04;1.82±0.01、1.82±0.01、1.79±0.03及1.79±0.02、1.79±0.01、1.79±0.04,与curosurf同各浓度血浆混合物比较,差异均有统计学意义(P均<0.05).不同浓度的高分子聚合物显著提高了血浆存在情况下curosurf降低γmin、增加SI的能力(rPEG=-0.718,P<0.01;rdextran=-0.682,P<0.01;rHA=-0.889,P<0.01).结论 高分子聚合物可以逆转血浆所致的curosurf失活,和PEG比较,dextran和HA与curosurf联合应用可以更好地对抗血浆的抑制.