海水淹溺性急性肺损伤兔几种细胞因子的动态变化  

Dynamic changes of several cytokines in lung tissue and serum of rabbit with acute lung injury induced by seawater drowning

作　　者：芮萌[1] 段蕴铀[1] 王海龙[1] 张新红[1] 王宇[1] 

机构地区：[1]海军总医院干一科,北京100037

出　　处：《中国急救医学》2009年第5期427-431,481,共6页Chinese Journal of Critical Care Medicine

摘　　要：目的探讨TNF—α、IL-1β、IL-6、IL-8、IL—10等细胞因子在海水淹溺性ALI中的作用。方法36只新西兰兔随机分成六组：0（对照组），灌注1、3、6、12、24h组，每组6只动物。灌注组经气管插管灌注2mL/kg海水。不同时间点观察各组动物血气分析的变化。计算肺湿干质量比（W／D）、肺通透指数（LPI）。以ELISA法检测肺组织和血清中TNF-α、IL-1β、IL-6、IL-8、IL-10表达水平，同时进行病理学检查，并计算肺病理评分。结果灌注海水后氧合指数迅速低至300以下，持续时间长达6h。W／D值于S3h达高峰，肺通透指数以S6h组数值最高。各时间点肺组织和血清中TNF-α、IL-1β、IL-8、IL-10均显著高于对照组（P〈0．05或P〈0．01）。TNF-α、IL-1β、IL-10高峰在6h，IL-8高峰在12h。血清IL-6于1h后持续在最高水平，肺组织IL-6浓度仅在6h时升高（P〈0．05）。肺大体标本于灌注后3h瘀血水肿最严重，体积最大。显微镜下炎症细胞浸润于6～12h最突出，肺泡间隔宽度随时间延长而加重。肺病理评分1h时已显著高于对照组（P〈0．01），6h达最高。LPI，肺组织和血清TNF-α、IL-1β、IL-8、IL-10及血清IL-6表达与肺损伤程度呈正相关（P〈0．05或P〈0．01），TNF-α与IL-1α、IL-10以及血清IL-6亦密切相关。结论TNF-α、IL-1β、IL-6、IL-8、IL-10等细胞因子以协同或拈抗的方式参与了海水淹溺性ALI的病理过程，全身性炎症反应和抗炎反应的失衡在海水淹溺性ALI发生发展中可能起重要作用。Objective To explore the roles of TNF-α, IL - 1β, IL-6, IL-8 and IL - 10 in pathogenesis of acute lung injuries induced by seawater drowning （ SWD -ALI ） in rabbit model. Methods Thirty -six New Zealand rabbits were randomly divided into 6 groups ：control group （0 h） and 5 seawater drowning groups （ S1h, S3h, S6h, S12h, S24h）. There were 6 rabbits at each group. The drowning model was established by pouring seawater（2 mL/kg） into tracheal catheter. Blood gas analysis of every rabbit was observed at different time. The lung wet to dry weight ratio （ W/D ） and lung permeability index （ LPI ） were calculated. The concentrations of TNF - α, IL - 1β, IL - 6, IL - 8 and IL - 10 in lung tissue and serum were detected by means of enzyme - linked immunosorbent assays （ ELISA ）. At the same time, the changes of pathology were shown by hematoxylin - eosin （ HE ） staining and lung pathologic scores were measured. Results After pouring seawater, Oxygenation index （PaO2/FiO2 ） fell to 203.76 ± 37.80 at 0.5 h and did not elevate to more than 300 until 6 h. The largest W/D ratio came forth at S3h group. The highest LPI appeared at S6h. group. The concentrations of TNF -α, IL - 1β, IL - 8 and IL - 10 in lung tissue and serum at each seawater drowning group were all higher than those in control group （P 〈 0.05 or P 〈 0.01）. The expressions of TNF-α, IL- 1β and IL- 10 climbed to the top at 6 h. IL- 8 peaked at 12 h. The level of serum IL -6 in each seawater drowning group had no significant difference between each other, but was higher than that in control group （ P 〈 0. 05 ）. IL - 6 of lung tissue just had a signifycant increase at S6h group （ P 〈0.01 ）. The lung specimen of S3h group had the largest volume and the most manifest edema and congestion. Furthermore, the histopathologic findings indicated that pulmonary sepatal thickened in time dependence and inflammatory cell infiltration was most massive at 6 - 12 h. Lung pathologic score of every seawater drowning

关 键 词：海水 淹溺 肺损伤 细胞因子 

分 类 号：R563[医药卫生—呼吸系统]