高频振荡通气联合肺表面活性物质对吸入性损伤肺组织天冬氨酸特异性半胱氨酸蛋白酶-3和p73的影响  

Effect of high frequency oscillatory ventilation combined with exogenous pulmonary surfactant on apoptosis of lung tissue in rabbit with acute respiratory failure induced by steam inhalation injury

作　　者：郭光华[1] 王少根[1] 付忠华[1] 吴星恒[2] 杨明[2] 陈晓[2] 

机构地区：[1]南昌大学第一附属医院烧伤科,江西南昌330006 [2]南昌大学第一附属医院儿科,江西南昌330006

出　　处：《中国危重病急救医学》2008年第6期327-330,共4页Chinese Critical Care Medicine

基　　金：国家自然科学基金资助项目（30460134）

摘　　要：目的探讨高频振荡通气（HFOV）联合肺表面活性物质（PS）对吸入性损伤兔肺组织细胞凋亡的影响。方法采用兔蒸汽吸入性损伤模型，将32只兔按不同通气治疗方式分为常规控制机械通气（CMV）组、HFOV组、CMV＋PS组及HFOV＋PS组4组，每组8只。治疗4h后处死动物，取右肺中叶组织，分别检测天冬氨酸特异性半胱氨酸蛋白酶-3（caspase-3）、p73的含量及其mRNA表达水平。结果①HFOV组和HFOV＋PS组肺组织caspase-3和p73的含量分别较CMV组和CMV＋PS组明显减少，差异有统计学意义（P〈0．05或P〈0．01）；加入外源性PS后，CMV＋PS组和HFOV＋PS组的caspase-3和p73含量也较相应未加入组明显减少，差异也有统计学意义（P均〈0．05）。③HFOV组和HFOV＋PS组caspase-3 mRNA和p73 mRNA表达分别较CMV组和CMV＋PS组明显减少，差异有统计学意义（P均〈0．01）；加入外源性PS后，CMV＋PS组和HFOV＋PS组肺组织caspase-3 mRNA和p73 mRNA的表达也明显低于相应未加入组，差异也有统计学意义（P均〈0．05）。结论与CMV或CMV＋PS比较，HFOV或HFOV＋PS能减少吸入性损伤肺组织细胞中caspase-3、p73的含量及其mRNA表达，从而可能减少通气肺的肺细胞凋亡。Objective To investigate the effect of high frequency oscillatory ventilation （HFOV） combined with exogenous pulmonary surfactant （PS） on apoptosis of lung tissue in rabbit suffering from steam inhalation injury. Methods Thirty-two New Zealand rabbits were randomly divided into four groups, and acute respiratory failure model was reproduced by severe steam inhalation injury. Then they were ventilated and treated by controlled mandatory ventilation （CMV）, HFOV, CMV ＋PS or HFOV ＋PS, respectively. After the animals were euthanized at 4 hours treatment time point, the right middle lobe of rabbit lung was harvested for the examination of caspase-3 and p73 contents and relative values, as well as mRNA expression of caspase-3 and p73. Results （1） Contents of caspase-3 and p73 in lung tissue homogenates in HFOV group and HFOV＋PS group were significantly lower than those in CMV group and CMV＋PS group （P〈0.05 or P〈0.01）, and also contents of caspase 3 and p73 in lung tissue homogenates in groups with exogenous PS were significantly lower than those of groups without exogenous PS （all P〈0.05）. （2） Caspase 3, p73 mRNA expressions in lung tissue in HFOV group and HFOV＋PS group were significantly lower than those of CMV group and CMV＋PS group （all P〈0.01）. Caspase-3 and p73 mRNA expression in lung tissue in groups with exogenous PS group were significantly lower than those of the corresponding group without exogenous PS （all P〈0.05）. Conclusion Compared with CMV or CMV＋ PS, HFOV or HFOV＋PS can decrease the concentration of caspase-3 and p73, reduce the mRNA expression of caspase-3 and p73 in the lung hemogenates, as a result lung tissue apoptosis in inhalation injury may be suppressed.

关 键 词：高频振荡通气 控制机械通气 肺表面活性物质 天冬氨酸特异性半胱氨酸蛋白酶-3 

分 类 号：R563.8[医药卫生—呼吸系统]