【作者】 涂建仁；

【导师】 温桂兰；

【作者基本信息】 江西医学院 ， 内科学， 2005， 硕士

【摘要】 目的: 评价高容量血液滤过(HVHF)治疗内毒素诱导犬急性肺损伤的疗效,探讨HVHF 治疗ALI/ARDS 的分子生物学机制。方法: 建立内毒素诱导犬急性肺损伤模型,随机分为两组,每组8 只,对照组应用Diapact CRRT 机假治疗(血液在体外循环,不接置换液,不超滤)和机械通气,治疗组应用Diapact CRRT 机进行HVHF和机械通气。监测呼吸力学、动脉血气指标,测定循环血中TNF-α、IL-6、IL-10 的含量和肺泡细胞NF-κB 的活性。结果: 1.内毒素静脉注入能成功诱导建立急性肺损伤模型;2.HVHF 治疗组动脉血气和呼吸力学明显改善;3. HVHF 减少循环血中炎症介质(如TNF-α、IL-6 和IL-10)含量;4.HVHF 治疗组肺泡细胞NF-κB 的活性降低。结论: 高容量血液滤过能减少ALI 犬循环血中炎症介质TNF-α、IL-6 和IL-10 含量、降低肺泡细胞核因子-κB 的活性,减轻炎症反应,改善ALI 犬呼吸力学和动脉血气。提示HVHF 将可能成为ALI/ARDS 治疗的新手段。HVHF 治疗犬ALI 的分子生物学机制涉及到炎症介质的清除和核因子-κB 活性的抑制。更多还原

【Abstract】 【Objective】To evaluate effect of high volume hemofiltration (HVHF) on endotoxin-induced acute lung injury in dog and investigate the molecular biology mechanism of HVHF treating ALI/ARDS. 【Methods】The created models of endotoxin-induced acute lung injury in dogs were divided into two groups randomly, each group including eight healthy hybrid male dogs. The control group was applicated mechanical ventilation with ventilator of New Port E100i and was not treated with HVHF, the experiment group was performed mechanical ventilation and HVHF with Diapact CRRT machine. The parameters of respiratory mechanics and arterial blood gases were monitored. The content of TNF-α、IL-6 and IL-10 in blood and the activity of NF-κB of the alveolar cells were detected and compared between the two groups. 【Results】1.The ALI model was successfully establishde by injetcing endotoxin into the dog vein. 2. Compared with the control group the parameters of respiratory mechanics and arterial blood gases in the experiment group were significantly improved. 3.The inflammation media TNF-α、IL-6 and IL-10 in circular blood were reduced by applying HVHF. 4. The activity of NF-κB of the alveolar cells in the experiment group was dropped. 【Conclusions】It was observed that the level of the inflammation media TNF-α、IL-6 and IL-10 in circular blood and the activity of NF-κB of lung tissues were markedly decreased and that respiratory mechanics and arterial blood gases were significantly improved after HVHF treatment. It is suggested from our study that HVHF will possibly be a new therapeutic method for ALI or ARDS. The molecular biologic mechanism by which HVHF plays role in treating ALI/ARDS involve in cleaning the inflammation media and depressing the activity of NF-κB.更多还原