N-去硫酸基团肝素对幼猪肠穿孔脓毒症诱发急性肺损伤治疗作用机制探讨  

The influence of N - desulfated heparin on IL - 2, IL - 8 and sVCAM - 1 in the serum of piglets with acute lung injury induced by sepsis

作　　者：韩俊毅[1] 卢爱国[1] 孙志扬[1] 范慧敏[1] 刘中民[1] 郑珊[2] 孙波[2] 

机构地区：[1]同济大学附属东方医院,上海200120 [2]复旦大学附属儿科医院,上海201102

出　　处：《中国急救医学》2009年第6期529-532,共4页Chinese Journal of Critical Care Medicine

摘　　要：目的通过观察白细胞介素-2（IL-2）、IL-8、可溶性血管细胞黏附分子（sVCAM-1）的变化，探讨N-去硫酸基团肝素对幼猪肠穿孔脓毒症诱发急性肺损伤治疗机制。方法23只雄性幼猪随机分为假手术对照组（A组，n=5）、模型组（B组，n=6）、N-去硫酸基团肝素治疗组（C组，n=6）、低分子肝素治疗组（D组，n=6），建立肠穿孔脓毒症诱发急性肺损伤模型后，机械通气基础上，在Au即刻，C组12ms／kgN-去硫酸基团肝素静脉注射，D组300U／kg低分子肝素静脉注射，观察比较基础状态、出现Au后4h、8h血清IL-2、IL-8、sVCAM-1水平。并比较支气管肺泡灌洗液白细胞浓度。结果C组支气管肺泡灌洗液白细胞计数明显低于B组和D组，其血清IL-2、IL-8在Au后短暂上升即均呈下降趋势，sVCAM-1持续下降。B、D组血清IL-2、IL-8、sVCAM-1在ALI后均呈明显上升。结论N-去硫酸基团非抗凝肝素对脓毒症诱发急性肺损伤的治疗作用可能和其降低血清IL-2、IL-8、sVCAM水平，从而抑制白细胞的趋化、黏附、活化有关。Objective To explore the influence of N - desulfated heparin on IL - 2, IL - 8 and sVCAM - 1 in the serum of piglets with acute lung injury induced by sepsis for better understanding of the mechanism of N - desulfated heparin. Methods 23 male piglets were randomly allocated to 4 groups： group A（ n = 5 ）, sham operation group ; group B （ n = 6）, model group without treatment; group C （ n = 6 ） , N - desulfated heparin treatment group and group D （ n = 6） as LMWH treatment group. Serum IL - 2, IL - 8 and sVCAM - 1 leavel were detected by ELISA. Results On the check point of basis status, d hours after ALl and 8 hours after ALl ; neutrophil count of bronchoalveolar lavage fluid （BALF） were also checked. Results In group C the serumal IL -2, IL -8 level elevated initially then declined after the onset of ALl while the seruma sVCAM level declined persistently. And compared with group B and group D, neutrophil count of bronehoalveolar lavage fluid was much lower in group C. After the onset of ALl the serumal IL- 2, IL- 8 and sVCAM level increased persistently in group B, and the serumal IL- 8 and sVCAM increased significantly. Group D showed the same tendency as group B although the elevation was not so significant as group B. Conclusion N - desulfated heparin can low the level of serumal IL - 2, IL - 8 and sVCAM - 1 of piglets with acute lung injury induced by sepsis, so it can inhibit leukocyte adhesion and transmigration which probably contributes to attenuating lung injuries.

关 键 词：N-去硫酸基团肝素 急性肺损伤 白细胞介素-2 白细胞介素-8 可溶性血管细胞黏附分子 

分 类 号：R563[医药卫生—呼吸系统]