【作者】 徐伟；

【导师】 谈永飞；

【作者基本信息】 江苏大学 ， 心胸外科， 2010， 硕士

【摘要】 目的：观察雾化吸入氟碳化合物(PFC)对急性肺损伤(ALI)大鼠肺表面活性物质、肺表面活性物质相关蛋白A(SP-A)与肿瘤坏死因子α(TNF-α)的影响。方法：选用健康雄性Sprague Dawley大鼠32只,体重250～300 g。采用腹腔注射脂多糖(LPS,8ml/kg)诱导急性肺损伤模型,并在LPS注射后1 h雾化吸入PFC 20 min进行干预,另设生理盐水(NS)对照组。在LPS注射后8 h,测定雾化吸入PFC 20 min对鼠动脉血气、死亡率与支气管肺泡灌洗液中总蛋白、双饱和磷脂酰胆碱(DPPC)、SP-A、TNFα浓度的影响。结果：与NS吸入相比,PFC吸入治疗组动物24 h内的死亡率下降,Pa02提高(P<0.01)；灌洗液中SP-A及DPPC的浓度增加(P<0.01),而蛋白浓度与TNF-α浓度则降低(P<0.01)。1.各组鼠PaO2、PaCO2的基础值均在正常范围,差异无统计学意义。LPS-NS组及LPS-PFC组动物PaO2较基础值明显下降(PaO2/FiO2<200)。与LPS-NS组比较,LPS-PFC组动物PaO2升高；PaCO2下降。两组死亡率之比为8：3,差异有统计学意义(P＜0.01)。2.与NS-NS组比较,LPS-NS组大鼠肺损伤病理评分3级,可见肺泡上皮细胞破坏、毛细血管阻塞、肺间质水肿、炎细胞浸润；PFC吸入组肺病理评分为1级,较LPS-NS组明显降低,差异有统计学意义(P<0.01)。3. NS-NS组和NS-LPS组动物的肺组织湿／干质量比值差异无统计学意义。与LPS-NS组比较,LPS-PFC组动物肺组织湿／干质量比值降低,差异有统计学意义(P<0.01)。4. NS-NS组和NS-PFC组动物的RBC、PMN与AM计数差异均无统计学意义。与LPS-NS组比较,LPS-PFC组动物RBC、PMN与AM计数明显减少,差异有统计学意义(P<0.01)。5.与NS-NS组比较,LPS-NS组动物BALF中TNF-α和TP浓度明显升高,而SP-A、DPPC浓度降低(P<0.05),与LPS-NS组比较,LPS-PFC组动物BALF中TNF-α与TP浓度明显降低,而SP-A与DPPC浓度明显升高(P<0.05)。结论：PFC雾化吸入降低LPS诱导的急性肺损伤动物的死亡率,提高机体的氧合。该作用可能与PFC雾化吸入增加肺损伤大鼠肺DPPC与SP-A的浓度,减少蛋白渗出与降低TNFα的浓度有关。更多还原

【Abstract】 Objective To investigate the effects of inhalation of perfluorocarbon (PFC) aerosol on lung surfactant, surfactant protein A (SP-A) and TNF-αin rats with acute lung injury.Methods Selection 32 healthy adult rats, each weighed 250-300g. Acute lung injury was induced by intraperitoneal injection of lipopolysaccharide (LPS,8mg/kg). One hour after LPS injection, PFC aerosol was inhalated for 20 minutes. The results were compared with the group, in which normal saline was used insead of LPS as the control. Eight hours after LPS injection the effects of PFC inhalztion on the artery blood gas, death incidence, and dipalmitoylphosphatidylchloline, SP-A, TNF-a and lung surfactant concentrations in bronchoalveolar lavage fluid (BALF) were measured by using ELISA or HPLC.Results After the inhalation of PFC, PaO2 increased significantly with relatively lower PaCO2 and death incidence in rats following acute lung injury than that in the group received NS inhalation (P＜0.01). Compared with the NS inhalation group, concentrations of SP-A and dipalmitoylphosphatidylchloline, the major component of lung surfactant in the BALF were higher (P<0 01), with a lower BALF concentration of TNF-a in PFC inhalation group (P<0 01). 1. The basic values of PaO2 and PaCO2 in each group of rats were normal and the difference was not statistically significant. Compared with the baseline, PaO2 decreased significantly (PaO2/FiO2<200) in group LPS-NS and LPS-PFC. Compared with the group LPS-NS, PaO2 increased, but PaCO2 decreased in group LPS-PFC; the ratio of mortality rates between group LPS-NS and LPS-PFC was 8:3 and the difference was statistically significant (P<0.01).2. Compared with the group NS-NS, lung alveolar epithelial cell damage, capillary obstruction, pulmonary interstitial edema, inflammatory cell infiltration could be observed in rats of group LPS-NS. The lung injury score was 3 which increased significantly. Compared with group LPS-NS, the lung injury score of group PFC aerosol inhalation was 1 which was significantly lower and the difference was statistically significant (P<0. 01).3. There were no difference of the W/D ratio of lung tissue between group NS-NS and LPS-NS. Compared with the group LPS-NS, the W/D ratio of lung tissue in group LPS-PFC was decreased and the difference was statistically significant(P<0.01).4. There were no difference of the RBC, PMN and AM counts between group of NS-NS and LPS-NS. The RBC, PMN and AM counts were statistically decreaesd in the group LPS-PFC compared with the group LPS-NS (P<0.01). 5. Compared with the group NS-NS, TNF-a and TP concentrations in BALF were significantly increased, and the SP-A, DPPC concentration were decreased in group LPS-NS (P＜0.05). While in group LPS-PFC, TP concentrations and TNF-a in BALF were significantly reduced, and SP-A and DPPC were significantly increased compared with the group LPS-NS (P<0.05).Conclusion Inhalation of PFC aerosol during the LPS-induced acute lung injury of rats can increase SP-A and surfactant concentration and decrease TNF-a concentration in BALF, which possibly be useful for the treatment of acute lung injury.更多还原