机械通气导致大鼠肺血管渗透性改变和肺细胞因子反应的关系  

Relationship between pulmonary vascular permeability and cytokine reaction induced by mechanical ventilation

作　　者：李克忠[1] 姚尚龙[1] 马利[1] 

机构地区：[1]华中科技大学同济医学院协和医院麻醉科,武汉430022

出　　处：《中华急诊医学杂志》2007年第1期26-29,共4页Chinese Journal of Emergency Medicine

基　　金：国家自然科学基金资助项目（30471661,30571787）

摘　　要：目的 研究两种通气模式在不同时间点导致大鼠肺血管渗透性改变和细胞因子反应的关系。方法 成年雄性SD大鼠96只，随机分为常规通气组（C组）和大潮气量组（N组）。每组分别在30min、60min、120min和180min放血处死大鼠，进行各种检测，每个时间点12只大鼠。实验结束时测定大鼠肺病理形态学评分、肺组织湿，干重比（W/D）、支气管灌洗液（BALF）炎性细胞、血管壁通透性、血浆里肿瘤坏死因子-α（TNF-α）和巨噬细胞炎性蛋白-2（MIP-2）浓度。结果 与C组比，机械通气30min时，N组肺病理形态学评分、W／D、EB含量升高（P〈0．05或P〈0．01）；在60min时，N组BALF中WBC显著升高（P〈0．01）；在120min时N组MIP-2才明显升高。两组TNF-α都没被检测到。结论 大潮气量通气导致的肺损伤和肺通透性改变发生很早，最初不需要TNF-α和MIP-2参与，也与白细胞浸润无关。Objective To study the relationship between pulmonary vascular permeability and eytokine reaction induced by mechanical ventilation . Method Ninty-six adult male SD rats were randomly divided into two groups： conventional ventilation group （C group, n =48） and high tidal volume ventilation group （N group, n =48）. Rats in C group received tidal volume （Vt） 8 ml, N group received Vt 40 ml group. At 30 minutes, 60 minutes, 120 minutes and 180 minutes, 6 rats in each time situs were not injected with EB at the beginning of the experiment for determination of vessel wall permeability . At the end of the experiment, morphological change scores, lung tissue wet-weight/dry-weight ratio （W/D）, inflammatory cell in bronchial lavage fluid （BALF）, plasma tumor necrosis faetor-α （TNF-α）, and the densities of maerophage inflammatory protein-2 （MIP-2） were determined. Results Compare with C group, lung morphological change scores , W/D, and the content of EB were increased （ P 〈 0.05 or P 〈 0.01 ） at 30 minutes in N group, WBC was increased remarkably （ P 〈 0.01 ） at 60 minutes, and MIP-2 elevated at 120 minutes markedly. TNF-α couldn＇t be determined in beth groups. Conclusions The change of vascular permeability and lung injury occurred early induced by large tidal volume ventilation. During early phase, such change had no relation with TNF-α and MIP-2 and leukoeytie infiltration.

关 键 词：机械通气 血管渗透性 细胞因子 

分 类 号：R686[医药卫生—骨科学]