急性肺血栓栓塞症兔溶栓或抗炎治疗时内皮素1和核因子-κB的表达水平  

The expression levels of endothelin-1 and nuclear factor-κB in the lung tissue of acute pulmonary embolism and the effects of thrombolysis and dexamethasone

作　　者：张斗霞[1] 张凌[1] 白明[1] 

机构地区：[1]华中科技大学同济医学院附属协和医院呼吸科

出　　处：《中华结核和呼吸杂志》2005年第9期604-607,共4页Chinese Journal of Tuberculosis and Respiratory Diseases

摘　　要：目的探讨兔急性肺血栓栓塞症(APTE)时肺血管内皮、支气管和肺泡上皮等部位内皮素1(ET-1)和核因子κB(NF-κB)的表达状况及尿激酶(UK)溶栓或地塞米松(Dex)抗炎治疗对其的影响。方法40只大耳白兔随机分为对照组、PTE模型组、UK组、Dex组和UK+Dex组,每组8只。采用自体血栓回输法建立动物模型。常规病理学检查和免疫组化法检测肺血管内皮、支气管和肺泡上皮等部位ET-1和NF-κB P65蛋白的表达水平。结果(1)病理检查显示PTE、UK和Dex组兔肺组织病理损伤明显,UK+Dex组肺组织损伤较轻。(2)免疫组化检测显示对照组肺血管内皮、支气管和肺泡上皮ET-1蛋白表达相对含量分别为0.138±0.007、0.063±0.003、0.066±0.002,PTE组分别为0.331±0.036、0.229±0.014、0.191±0.046,UK组分别为0.204±0.020、0.163±0.017、0.137±0.013,Dex组分别为0.258±0.032、0.188±0.013、0.145±0.055,UK+Dex组分别为0.186±0.033、0.107±0.012、0.098±0.026,各组间差异有统计学意义(F值分别为74.51、259.15、87.16,P分别<0.01、<0.05);对照组肺血管内皮、支气管和肺泡上皮NF-κB P65蛋白表达相对含量分别为0.074±0.020、0.066±0.028、0.044±0.026,PTE组分别为0.245±0.036、0.190±0.040、0.204±0.054,UK组分别为0.278±0.039、0.225±0.058、0.210±0.139,Dex组分别为0.175±0.024、0.104±0.022、0.144±0.022,UK+Dex组分别为0.109±0.018、0.062±0.023、0.093±0.019,各组间差异有统计学意义(F值分别为329.52、356.65、190.55,P<0.01)。PTE、UK和Dex组ET-1蛋白表达的相对含量显著高于对照组,UK+Dex组与对照组比较差异无统计学意义。PTE组和UK组NF-κB P65蛋白表达的相对含量显著高于对照组、Dex组、UK+Dex组,Dex组高于对照组,UK+Dex组与对照组比较差异无统计学意义。结论APTE后溶栓结合抗炎治疗可明显降低ET-1和活化的NF-κB介导的急性肺损伤,提示对PTE患者开展溶栓治疗的同时,也要重视必要的抗炎治疗和内皮素抑制�Objective To study the expression levels of endothelin-1 （ ET-1 ） and nuclear factor-kB （NF-kB） in lung vascular endothelium, bronchial and alveolar epithelia in acute pulmonary thromboembolism（APTE） , and to explore the effects of thrombolytic （urokinase, UK） or ant-inflammatory therapy （dexamethasone, Dex） on their expressions. Methods Forty rabbits were randomly divided into a control（C） group, a pulmonary thromboembolism（PTE） model group, an UK therapy group, a Dex therapy group, and an UK ＋ Dex therapy group, with 8 rabbits each. The PTE model was established by intravenous injection of autologous blood clots. The pathological changes of the lung were examined with light microscope. By using immunohistochemistry, the expression levels of ET-1 and NF-kB P65 in lung vascular endothelium, bronchial and alveolar epithelia were examined. Results Histopathological study showed that lung injury was evident in the PTE, UK and Dex groups, but was mild in the UK ＋ Dex group. In the PTE group, the expression levels of ET-1 in lung vascular endothelinm, bronchial and alveolar epithelia were 0. 331±0. 036, 0. 229±0. 014 and 0. 191±0. 046, respectively, while the expression levels of NF-kB P65 were 0. 245±0. 036, 0. 190±0. 040 and 0. 204±0. 054, respectively. Their levels were significantly higher as compared to those of the control group and the UK ＋ Dex group （ all P 〈 0. 01 ）. In the UK group, the ET-1 expression in lung vascular endothelium, bronchial and alveolar epithelia were 0. 204±0. 020, 0. 163±0. 017 and 0. 137±0. 013 respectively, significantly lower as compared to the PTE group （ all P 〈 0. 05）. In the Dex group, the NF-kB P65 expression was 0. 175±0. 024, 0. 104±0. 022 and 0. 144±0. 022 respectively, the difference being significant as compared with the PTE group（ all P 〈0. 05 ）. In the UK ＋ Dex group, the ET-1 expression was 0. 186±0. 033, 0. 107±0. 012 and 0. 098±0. 026 respectively, significantly different from the PTE group （all P 〈

关 键 词：急性肺血栓栓塞症 动物实验 溶栓治疗 抗炎治疗 内皮素1 核因子-KB 基因表达 兔溶栓 

分 类 号：R563.5[医药卫生—呼吸系统] R-332[医药卫生—内科学]