冲击波复合四氧化二氮染毒致冲毒复合伤对大鼠血气变化及病理形态学的影响和c-fos基因表达的研究  

The changes in blood gases,pathomorphologic examination and c-fos expression in rats following blast-toxic combined injury by explosion of nitrogen tetroxide

作　　者：岳茂兴[1] 彭瑞云[2] 王德文[2] 王正国[3] 杨鹤鸣[1] 杨志焕[3] 夏亚东[3] 高亚兵[2] 崔雪梅[2] 李建忠[1] 

机构地区：[1]解放军第306医院特种医学科,北京100101 [2]军事医学科学院北京,100073 [3]重庆第三军医大学野战外科研究所

出　　处：《感染．炎症．修复》2002年第2期106-109,共4页Infection Inflammation Repair

基　　金：解放军总装备部卫生局重点指令性攻关课题(No.200010306);全军医学科学技术研究"十五"计划指令性项目(No.01L15)

摘　　要：目的:探讨冲击波复合四氧化二氮(N_2O_4)染毒致冲毒复合伤对大鼠血气及病理形态学的影响,以及该条件下 c-fos 基因的表达及其意义。方法:采用 Wistar 雄性大鼠复制冲击伤、N_2O_4中毒及复合效应的3组动物模型,均于伤后3、6、12、24、48、72h 活杀,进行主要器官病理形态学检查及血气分析,并采用 SP 免疫组化技术观察肺组织 c-fos 基因表达的变化。结果:三组动物 PaO_2均在伤后3～6 h 内显著下降,冲毒复合伤组动物伤后 PaO_2下降最为显著,重者死于呼衰。三组动物的主要病理形态学均有改变,以冲毒复合伤组的损伤最重;冲击伤和 N_2O_4组 c-fos 基因表达均明显增加,而于复合伤组表达持续呈强阳性,其阳性部位以支气管上皮、血管内皮和单核细胞为主。结论:单纯中度冲击伤组和单纯中度 N_2O_4组中毒早期血气均有显著变化;复合伤对血气的影响更为显著。另外,三组动物的主要病理形态学均有改变,以复合伤组的损伤最重;结果表明 c-fos 基因表达可能参与复合伤对肺损伤的加重过程,提示对冲毒复合伤进行早期救治(在3～6h 内)的重要性。Objective:To investigate the changes in blood gases,pathomorphologic features and c-fos expression in rats following blast-toxin combined injury producced by explosion of nitrogen tetroxide.Methods:The blastinju- ry,intoxication of nitrogen tetroxide and the blast-intoxication combined injury models were reproduced,and the animals were respectively killed at 3,6,12,24,48 and 72 hours after injury to observe the changes in pathomor- phologic manifestation,blood gases and c-fos gene expression.Results:The PaO_2 values of animals in all three models,particularly in blast-intoxication combined model,were significantly decreased at 3～6 hours after injury, and some of them died from respiratory failure.Each group showed pathomorphologic alterations in vital organs, and the changes in rats of blast-intoxication combine model were the worst.Immunohistochemical staining revealed that c-fos gene expression was significantly enhanced in three groups,showing a persistent positive expression in animals with blast-intoxication combined injury,c-fos gene expressed mainly in monocytes and the epithelium of bronchus and blood vessels.Conclusion:Blast injury and intoxication of nitrogen tetroxide could producce signifi- cant lowerig of PaO_2,and the combined injury of blast and intoxication of nitrogen tetroxide could cause even more lowering of PaO_2,with obvious pathomorphologic alterations in viscerae.In addition,these data indicated that c- fos expression might be associated with the development of acute lung injury following blast-intoxication combined injury.

关 键 词：冲击波 四氧化二氮 冲毒复合伤 肺损伤 c-fos 基因 

分 类 号：R82[医药卫生—临床医学]