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本文在家兔以双指示剂稀释技术对左心房加压所致的实验性压力性肺水肿进行了研究。在兔左心房内插入双腔气囊导管,以观察及升高在心房压(Pla)。在左心房加压前后,分别采用双指示剂测定指示剂肺血管外水量(IEVLW)的变化,其中~(51)Cr-RBC作为不可弥散性指示剂,氚水作为可弥散指示剂。依据两种指示剂平均通过肺循环的时间差(l_w—l_b)与心输出量之积计算出IEVLW。同时,与Pearce法测得的死后肺血管外水量(PEVLW)进行比较。结果表明,_wt—t_b自左心房加压前的0.9328±0.0841s增至1.5422±0.1417s(P<0.001,n=8),IEVLW从4.867±0.526ml增至8.057±0.700ml(P<0.01)。相应的PEVLW为9.36±0.63g,IEVLW/PEVLW比值为87.3±7.2％。实验资料表明,左心房压力升高与肺静脉回流受阻改变了肺微血管静力压,致使肺血管外水量发生有意义的改变。双指示剂稀释技术可用于观察兔的肺水动态变化。IEVLW/PEVLW比值较高,反映即使在左心房压力恢复后的短时间内,肺水的交换运动仍较活跃。
In this paper, double-indicator dilution in rabbits experimental left atrial pressure of experimental pressure pulmonary edema were studied. A double-lumen balloon catheter was inserted into the left atrium of the rabbit to observe and elevate the pressure in the atria (Pla). Before and after pressure in the left atrium, two indicators were used to measure the changes of indicator extravascular pulmonary volume (IEVLW). Among them, ~ (51) Cr-RBC was used as a non-dispersible indicator and tritiated water as a dispersible indicator. The IEVLW was calculated as the product of the time difference (l_w-l_b) and the cardiac output of the two indicators passing through the pulmonary circulation on average. At the same time, the Pearce method was used to compare the post-mortem pulmonary extravascular volume (PEVLW). The results showed that _wt-t_b increased from 0.9328 ± 0.0841s before left atrial pressure to 1.5422 ± 0.1417s (P <0.001, n = 8), IEVLW increased from 4.867 ± 0.526ml to 8.057 ± 0.700ml (P <0.01) . The corresponding PEVLW was 9.36 ± 0.63g and the IEVLW / PEVLW ratio was 87.3 ± 7.2%. Experimental data show that left atrial pressure and pulmonary venous obstruction has changed the pulmonary microvascular static pressure, resulting in a significant change in pulmonary extravascular volume. Dual indicator dilution technique can be used to observe the dynamic changes of lung water in rabbits. The IEVLW / PEVLW ratio was higher, reflecting a more active exchange of lung water even within a short period of time after left atrial pressure was restored.