【摘要】 目的探讨沐舒坦(盐酸氨溴索)对胎粪吸入综合征的保护作用及机制。方法将45只幼兔分为模型组(n=20)、沐舒坦组(n=20)和正常对照组(n=5),建立幼免胎粪吸入模型;在胎粪吸入后16、24、48、72小时计数支气管肺泡灌洗液(BALF)白细胞(WBC)、中性粒细胞(PMN)和肺泡巨噬细胞(AM)数,并采用放射免疫法测定肺组织匀浆液及BALF中肿瘤坏死因子-α(TNF-α)含量,在显微镜下观察肺损伤的程度。结果同对照组相比,模型组BALF中PMN和WBC数升高,AM数量减少,肺组织匀浆液和BALF中TNF-α含量明显升高,差异有统计学意义(P<0.01),其中在24小时达高峰,72小时仍改变明显,且肺组织病理改变明显。同对照组相比,沐舒坦组上述指标呈现类似改变,但在72小时与正常组相比差异无统计学意义(P>0.05),而同模型组相应时间点相比,沐舒坦组上述指标中除AM数量无变化(P>0.05)外,其余指标降低,差异有统计学意义(P<0.01),肺损伤程度明显减轻。结论幼免胎粪吸入后,肺部产生明显的炎症反应,TNF-α在胎粪吸入综合征的发生发展中占有重要的作用;沐舒坦可通过减少TNF-α的分泌,保护胎粪吸入所致的肺损伤。更多还原

【Abstract】 Objective To investigate the protective effect of ambroxol hydrochoride and its mechanism on meconium aspiration syndrome in immature rabbits. Methods Forty five immature rabbits were randomly divided into three groups: model group(20 rabbits), ambroxol hydrochoride group(20 rabbits) and control group(5 rabbits).The animal model was established by endotracheal intubation imbuing 20% meconium (0.6 ml/kg). At 16,24,48 and 72 hour after instillation, the number of white blood cells (WBC), polymorphonuclear neutrophils(PMN) and alveolar macrophages (AM) in bronchoalveolar lavage fluid (BALF) was calculated; the level of tumor necrosis factor-α(TNF-α) in lung tissue and BALF was measured by radioimmunoassay; and the pathological changes of lung tissues were observed under microscope. Results Compared with control group, WBC, PMN, TNF-α were significantly increased, and AM was significantly decreased in model group(P<0.01). The most conspicuous disparity was noted at 24 h after instillation and they were still higher at 72 h. The pathological changes of lung tissues were obvious. These variables of ambroxol hydrochoride group were similar with control group at every detecting point except at 72 h; compared with model group however, these variables were significantly decreased except AM along with a slight pathological change of lung tissues. Conclusion Aspirating meconium could induce remarkable pulmonary inflammatory response in immature rabbits. TNF-α may play an important role in the development of MAS. Ambroxol hydrochoride could protect lung injury resulting from meconium aspiration through retarding the production of tumor necrosis factor-α in lung tissues.更多还原