透明质酸钠对兔脓胸胸膜粘连及纤维化的影响  

Effect of sodium hyaluronate on pleurai adhesions and fibrosis in a rabbit model of empyema

作　　者：马长秀[1] 孙耕耘[1] 王玉梅 

机构地区：[1]安徽医科大学第一附属医院呼吸内科,合肥230022 [2]深圳市南山区西丽人民医院呼吸内科

出　　处：《中华结核和呼吸杂志》2007年第4期289-293,共5页Chinese Journal of Tuberculosis and Respiratory Diseases

基　　金：安徽省优秀青年科技基金(200112)

摘　　要：目的探讨透明质酸钠对兔脓胸胸膜粘连及纤维化的影响。方法 20只雄性新西兰大白兔随机分为治疗组和对照组,每组10只。在右侧胸膜腔放置导管后,相继注入松节油和金黄色葡萄球菌以诱导脓胸形成,24 h 时抽取全部胸腔积液,脓胸被证实后,治疗组胸膜腔内注入透明质酸钠3 ml(30 mg),对照组注入生理盐水3 ml。所有动物于24 h 后肌内注射青霉素20万 U/d。96 h 时再次抽取胸腔积液,检测2次胸腔积液中的白细胞数、中性粒细胞比值、蛋白含量、葡萄糖浓度及 pH值。第8天处死兔并开胸观察。结果每组各有9只兔完成实验,治疗组和对照组96 h 时胸腔积液中白细胞数分别为(25±13)×10~9/L 和(37±10)×10~9/L,中性粒细胞比值分别为0.27±0.11和0.50±0.11,蛋白含量分别为(30±4)g/L 和(36±4)g/L,治疗组均显著低于对照组,96 h 胸腔积液中治疗组葡萄糖浓度为(2.4±0.5)mmol/L,显著高于对照组的(3.8±1.3)mmol/L。治疗组和对照组胸膜粘连积分分别为(0.7±0.5)和(3.2±0.7)分,脏层胸膜厚度分别为(28±10)μm和(156±42)μm,成纤维细胞数分别为(37±15)个/mm^2和(163±58)个/mm^2,治疗组均明显少于对照组。结论早期胸膜腔内注入高分子量透明质酸钠可显著减轻兔脓胸胸膜粘连及纤维化,且安全性好。Objective To study the effect of sodium hyaluronate（SH） on pleural adhesions and fibrosis in experimental empyema. Methods Twenty rabbits were randomly divided into two groups, a treatment group and a control group, 10 rabbits in each group. Chest tubes were placed into the right pleural cavity of the rabbits. Empyema was induced via intraplenral injection of turpentine followed by instillation of 10^8 CFU Staphylococcus aureus into the pleural space 3 h later. After an empyema was verified by plenral fluid analysis at 24 h, SH 3 ml （30 mg） was introduced into the right pleural cavity in the treatment group, but normal saline 3 ml was used in the control group. The rabbits received procaine penicillin G, 200 000 U intramuscularly daily after 24 h. Pleural effusion was analyzed at 24 h and 96 h. All animals were sacrificed on Day 8. Results Eighteen rabbits completed the experiment, 9 rabbits in each group. Pleural fluid analysis at 96 h in the treatment group and the control group showed that, leukocyte count was （ 24.7 ± 13. 0） × 10^9/L and （ 36.9 ± 10.1 ） × 10^9/L, respectively; neutrophil percentage was （ 27.1 ± 11.2 ） % and （49. 6 ± 10.9 ） %, respectively; protein was （ 30. 1 ± 3.6 ） g/L and （ 35.6 ± 4. 3 ） g/L, respectively. The three parameters of the treatment group were significantly lower than those of the control group（ P 〈0.05 ）. The level of glucose was （ 2.44 ± 0.52） mmol/L at 96 h in the treatment group and significantly higher than the control group （3.78 ± 1.28 ） mmol/L （ P 〈 0.05 ）. In the treatment group and the control group the pleuredesis score was 0.7 ± 0.5 and 3.2 ± 0.7, respectively; visceral pleural thickness score was （28 ± 10 ） tun and （ 156 ± 42） tun , respectively; and fibroblast score was （ 37 ± 15）/mm^2 and （ 163 ± 58）/mm^2, respectively. The above parameters of the treatment group were significantly lower than those of the control group. Conclusion Early intrapleural injection of a high molecular we

关 键 词：透明质酸 脓胸 胸膜 肺纤维化 

分 类 号：R96[医药卫生—药理学]