不同液体治疗对急性肺损伤大鼠肺泡上皮细胞屏障功能的影响  

Effects of the treatment with different fluids on alveolar epithelium barrier in rats with acute lung injury

作　　者：魏洪霞[1] 杨毅[2] 邱海波[2] 郭涛[2] 赵明明[2] 陈秋华[2] 

机构地区：[1]东南大学附属第二医院感染科,江苏南京210003 [2]东南大学附属中大医院危重病医学科,江苏南京210009

出　　处：《中国危重病急救医学》2009年第7期412-415,共4页Chinese Critical Care Medicine

基　　金：江苏省医药卫生指导性课题（Z200619）;江苏省医学领军人才基金项目（200650-11）;江苏省医学重点人才基金项目（RC2007111）

摘　　要：目的观察不同液体治疗对急性肺损伤（ALI）大鼠肺泡上皮细胞屏障功能的影响。方法36只清洁级SD大鼠随机分成6组，每组6只。静脉注射脂多糖（LPS）复制大鼠ALI模型；各干预组给予不同的液体治疗，4h后放血处死动物。处死前0．5h静脉注射伊文思蓝，处死前取血，处死后用生理盐水（NS）灌洗肺泡，测定肺泡上皮通透性及肺组织湿／干重（W／D）比值；用逆转录-聚合酶链反应（RT—PCR）测定肺组织中表面活化蛋白C（SP—C）mRNA表达；原位末端缺刻标记法（TUNEL）检测肺泡上皮细胞凋亡情况；观察肺组织病理学改变，并进行肺损伤半定量评分。结果①与对照组比较，LPS组、NS组肺损伤评分明显升高（P均〈0．05）；与NS组比较，5％人血白蛋白（ALB）组、6％羟乙基淀粉130／0．4（HES）组评分均明显降低（P均〈0．05），4％琥珀酰明胶（GEL）组无明显差异（P〉0．05），且后3组间比较差异也无统计学意义。②与对照组比较，LPS组、NS组肺W／D比值明显升高（P均〈0．05）；ALB组、HES组、GEL组均较NS组明显下降（P均〈O．05），3组间比较无差异。③LPS组、NS组肺泡上皮通透性均较对照组明显升高（P均〈0．05）；ALB组、HES组、GEL组肺泡上皮通透性均较NS组明显降低，且后两组明显低于ALB组（P均〈0．05），但仍高于对照组。④LPS组、NS组、ALB组、GEL组肺组织SP—CmRNA表达较对照组、HES组明显下降（P均〈0．05）；而HES组和对照组间无明显差异（P〉0．05）。⑤各组肺泡上皮细胞凋亡指数（AI）明显高于对照组（P均〈0．05）；ALB组、HES组AI较NS组明显下降（P均〈0．05），但与GEL组无明显差异（P均〉0．05）。结论胶体液较NS更能改善ALI大鼠肺泡上皮通透性，保护上皮细胞屏障功能。Objective To observe the effects of different fluids on alveolar epithelium barrier in rats with acute lung injury （ALI）. Methods Thirty-six Sprague-Dawley （SD） rats were randomly assigned into six groups with 6 rats in each group. ALI was induced by intravenous injection of lipopolysaccharide （LPS）. Rats in all treatment groups were given different fluids and sacrificed after 4 hours. Evans blue dye （EBD） was injected via the femoral vein 30 minutes before death. Tracheobronchial tree was washed with normal saline （NS） after death, and broncho-alveolar lavage fluid （BALF） was collected. Leakage of EBD from blood into BALF （alveolar epithelial permeability） and wet/dry （W/D） ratio were measured. The mRNA expression of surfactant protein-C （SP-C） was assessed by reverse transcription-polymerase chain reaction （RT-PCR）. Alveolar epithelium apoptosis was detected by terminal deoxynucleotidyl transferase-mediated dUTP biotin nick end labeling （TUNEL）. Lung injury was evaluated by Smith lung injury score. Results （1）Lung injury scores in LPS and NS groups were significantly higher than in control group （both P〈0.05）. Compared with NS group, lung injury scores were significantly lower in 5% albumin （ALB） and 6% hydroxyethyl starch 130/0.4 （HES） groups （both P〈0. 05）, and there was no significant difference in 4% succinylated gelatin （GEL） group （P〉0.05）. No significant difference was found among the latter three groups. （2）W/D ratio in LPS and NS groups were significantly higher than that in control group （both P〈 0. 05）. Compared with NS group, W/D ratios were lower in ALB, HES and GEL groups （all P〈0. 05）. But it showed no significant difference among the latter three groups.（3） Alveolar epithelial permeability in LPS and NS groups were remarkably higher than that in control group （both P〈0.05）. Compared with NS group, the alveolar epithelial permeability were significantly lower in ALB, HES and GEL groups （all P

关 键 词：急性肺损伤 液体 肺泡上皮细胞 大鼠 

分 类 号：R686[医药卫生—骨科学]