全氟化碳联合沐舒坦雾化吸入对兔急性肺损伤的影响  

Effect of combining aerosolization of perfluorocarbon and ambroxol in rabbits with acute lung injury

作　　者：黄志坚[1] 李琦[1] 宋鹏[1] 王长征[1] 钱桂生[1] 

机构地区：[1]第三军医大学新桥医院全军呼吸内科研究所全军呼吸病研究重点实验室,重庆400037

出　　处：《第三军医大学学报》2007年第6期490-493,共4页Journal of Third Military Medical University

基　　金：全军"十一五"医学科学研究基金(06G083)~~

摘　　要：目的观察雾化吸入全氟化碳(perfluorocarbon,PFC)及盐酸氨溴素(商品名沐舒坦)对兔急性肺损伤肺组织病理改变、气体交换、TNF-α mRNA及抗氧化方面的影响。方法用油酸制备兔急性肺损伤(acute lung injury,ALI)模型后,将动物随机分为4组:常规机械通气(A)组、全氟化碳(B)组、沐舒坦(C)组,联合治疗(D)组。分别在ALI前、ALI及ALI后1、2、3、4h共6个时点观察动脉血气指标的变化,实验结束后取6个不同部位的肺组织做病理切片,取2个不同部位的肺组织做TNF-α mRNA原位杂交,肺组织匀浆检测丙二醛(MDA)。结果D组PaO2及肺静态顺应性(static lung compliance,CLst)高于A组,与B组比较无差异(P>0·05);D组病理改变轻于A组,原位杂交提示D组TNF-α mRNA原位表达低于A组和B组,自身比较结果显示:背侧肺叶TNF-α mRNA表达高于腹侧肺叶(P>0·05)。D组肺组织匀浆MDA低于A组和B组(P<0·05)。结论PFC联合沐舒坦雾化吸入能明显改善实验兔ALI肺氧合能力,升高PaO2,改善肺静态顺应性,减少肺组织中的TNF-α mRNA表达及自由基的损害。Objective To observe the effect of aerosolized perfluorocarbon （PFC） （FC77） and ambroxol on gas exchange, histopathological changes of lung after acute injury, pulmonary expression of tumor necrosis factor-α mRNA （TNF-α mRNA） and antioxidation. Methods After acute lung injury （ALI） was induced by oleic acid （ OA）, thirty-two rabbits were assigned randomly to 4 groups ： conventional mechanical ventilation group （A）, aerosolized PFC group （B） , aerosolized ambroxol group （C） and combined aerosolization group （D）. The changes of gas exchange were examined before ALl, during ALl and at 1st, 2nd, 3rd, 4th h after ALI, and histological sections taken from 6 different parts of lung were stained by HE. The expression of TNF- α mRNA in the 2 different parts of lung were detected by in situ hybridization （ISH）, malondialdehyde （MDA） levels in lung homogenate was determined by the thiobarbituric acid （TBA） reaction. Results The PaO2 and static lung compliance （CLst） in group D significantly increased compared with group A （ P 〈 0. 05 ）, but showed no significant difference with group B. The histopathological lesions of lung were less severe in group D than group A. The TNF-α mRNA expression significantly decreased in group D as compared with groups A and B （P 〈0.05）, and was more in backside of lung than foreside of lung in four groups （P 〈 0. 05 ）. The MDA levels in lung tissues decreased in group D compared with groups A and B （P 〈 0. 05 ）. Conclusion The combined aerosolization of perfluorocarbon （PFC） and ambroxol can decrease tumor necrosis factor-α mRNA expression, lessen the injury caused by free radical in lung, improve the CLst and oxygenation of lung, increase PaO2 during acute lung injury.

关 键 词：急性肺损伤 全氟化碳 盐酸氨溴素 病理 肿瘤坏死因子-Α 

分 类 号：R452[医药卫生—治疗学] R563[医药卫生—临床医学]