【摘要】 目的盲肠结扎穿孔导致大肠埃希菌腹膜炎进而建立脓毒症肺损伤大鼠模型,检测炎性反应时,细胞因子的调控变化,探讨肺水肿的形成机制。经复方清下汤处理后检测上述变化。方法将健康SD大鼠随机分为4组,每组10只:假手术组(SHAM组),只翻动盲肠,不做其他处理;脓毒血症肺损伤组(模型组),盲肠结扎穿孔诱发急性肺损伤(ALI)模型;盲肠结扎穿孔+复方清下汤组(造模后立即灌胃给药,造模后8 h再次灌胃1次,剂量:10 ml/kg);盲肠结扎穿孔+头孢哌酮舒巴坦组(抗生素舒普深)(造模后立即静脉注射1次,造模后8 h再次静脉注射1次,剂量:0.2 g/kg),造模24 h后收集标本。分别观察大鼠的一般状态,留取下腔静脉血清进行白介素-1(IL-1)、白介素-6(IL-6)的测定。镜下观察肺组织病理形态学改变,测量肺湿/干比值的变化。结果与SHAM组比较,模型组IL-1、IL-6水平明显升高(P<0.01),肺间质和肺泡内水肿,伴大量红细胞渗出(出血)和纤维素沉积,肺泡间隔毛细血管内皮细胞高度肿胀。肺湿/干比值明显增加(P<0.01),抗生素及中药处理组与模型组比较,IL-1、IL-6水平明显降低(P<0.01),肺湿/干比值明显降低(P<0.01),肺组织镜下表现:中药处理组及抗生素组组较模型组肺泡间隔变窄,毛细血管内皮细胞肿胀减轻,出血减轻,纤维素渗出明显减少。结论实验应用放免检测、显微镜观察以及称量肺湿/干比值等手段,进一步证实了脓毒血症大鼠肺损伤时血清中主要的炎性细胞因子IL-1、IL-6过度表达的情况,并从病理学角度,证实炎性介质的过度表达是造成脓毒症肺损伤的重要原因。经复方清下汤处理的动物模型得到相反结论,为治疗脓毒血症大鼠肺损伤提供一个可能的新的手段。更多还原

【Abstract】 Objective To investigate the modulation of IL-1 and IL-6 on sepsis-induced acute lung injury(ALI) and the role of Fufangqingxiatang in these effects.Method SD rats were divided into four groups: SHAM group(n=10): the rats didn’t undergo any operation;ALI group(n=10): the cecum were ligated and produec intestinal perforation and induce ALI;FFQX group(n=10): FFQX(10 mg/kg) were administrated by lavage immediately and 8 hours after formation of ALI respectively;antibiotics group(ALI+Cefoperazone-Sulbactam,pfizer,n=10): Cefoperazone-Sulbactam(0.2 g/kg) were administrated by intravenous injection immediately and 8 hours after formation of ALI respectively.Specimen were collected 24 hours after ALI.Result The level of serum IL-1 and IL-6 in homogenate were significantly increased in ALI group compared with SHAM group(P<0.01).Pulmonary interstitial and intra-alveolar edema with exudate of RBCs and deposit of fibrin were seen.Endothelial cell of alveolar septum capillaries were obviously swollen.The ratio of W/D in ALI group was higher than that in SHAM group(P<0.01).Compared with ALI group,the level of serum IL-1 and IL-6 in homogenate were significantly decreased and the ratio of W/D was lower in FFQX group and antibiotics group(P< 0.01 each).Narrowed alveolar septum,slight endothelial cell swelling and decreased bleeding and exudate could be seen in both FFQX group and antibiotics group.Conclusion Overexpression of several major inflammatory factors such as IL-1 and IL-6 in sepsis-induced ALI rat model may be the result of sepsis-induced ALI.FFQX can decrease the secretion of it,also can alleviate the extent of sepsis-induced acute lung injury.更多还原