硫化氢对大鼠舱室内肢体爆炸伤后肺损伤的作用  

Effects of hydrogen sulfide on lung damage after limb's explosive injury in closed space in rats

作　　者：莫立稳[1] 赖西南 甯交琳[1] 王丽丽[1] 郭东阳[1] 

机构地区：[1]第三军医大学大坪医院野战外科研究所第六研究室创伤,烧伤与复合伤国家重点实验室,重庆400042 [2]成都军区总医院肾脏科,四川成都610083

出　　处：《创伤外科杂志》2009年第5期443-447,共5页Journal of Traumatic Surgery

基　　金：全军"十一五"指令性课题基金资助(06Z034)

摘　　要：目的研究外源性硫化氢(H2S)对大鼠舱室内肢体爆炸伤后肺损伤的作用,探讨H2S相关药物在舱室战伤救治中的应用价值。方法80mg二硝基重氮酚(DDNP)纸制点爆源紧贴大鼠左后肢跗关节内侧于舱室内引爆致伤。大鼠随机分为单纯致伤组(E组:n=32)、致伤+硫氢化钠(NaHS)组(S组:5mg/kgNaHS,ip;n=16)和正常对照组(C组:n=8)。收集大鼠肺组织和血标本。测定大鼠胸部承受冲击波压力,测定肺组织胱硫醚-γ-裂解酶(CSE)活力和血浆H2S浓度、TNF-α、IL-6、IL-10浓度和肺含水量,观察肺组织病理学变化。结果爆炸致伤后大鼠肺组织CSE活力和血浆H2S浓度显著下降(P<0.05),TNF-α、IL-6、IL-10浓度及肺含水量较正常对照大鼠相应值显著升高(P<0.05或P<0.01),肺出血、水肿、炎细胞浸润和肺泡结构破坏明显;而早期给予5mg/kgNaHS后伤鼠肺组织TNF-α、IL-6、IL-10浓度及肺含水量显著降低(P<0.05,vsE组),肺出血、水肿和炎细胞浸润程度明显减轻。结论大鼠舱室内肢体爆炸伤可引起严重的肺损伤;而早期适量给予H2S则可明显抑制肺炎性反应水平,减轻爆炸伤后肺损伤。Objective To study the effects of hydrogen sulfide （ HE S ） on lung damage after limb＇ s explosive injury in closed space in rats, and discuss the clinical value of HE S in the therapy for explosive injury. Methods Limb＇ s explosive injury in closed space was adopted. Healthy male Sprague-Dawley rats （ 200 ～220g ）were randomly divided into simple explosive injury group （ E group, n = 32 ）, explosive injury ＋ NariS group （ S group： 5mg/kg NaHS,ip,n = 16） and control group（ C group：n =8）. Lung and blood samples were collected. The pressure of blast injury, CSE activity in lung homogenate, H2S concentration in plasma, TNF-α, IL-6, IL-10 concentrations in lung homogenate and lung water content were detected. Pathological change of lung was observed. Results After explosion, CSE activity in lung homogenate and HES concentration in plasma decreased markedly（ P 〈 0.5, vs C group） ;TNF-α,IL-6 ,IL-10 concentrations in lung homogenate and lung water content increased markedly（ P 〈 0.05 or P 〈 0. 01, vs C group ） , and showed severe pneumorrhagia, pneumonedema, inflammatory cell infiltration and alveoli pulmonum disorganization. But in S group,TNF-α,IL-6, IL-10 concentrations and lung water content decreased significantly （ P 〈 0. 05 or P 〈 0. 01, vs E group ） , and pneumorrhagia, pneumonedema and inflammatory cell infiltration relieved significantly. Conclusion Limb＇ s explosive injury in closed space could lead to severe lung damage. But injecting H2S in the early stage can relieve lung damage after explosive injury.

关 键 词：爆炸伤 肺损伤 肢体 硫化氢 

分 类 号：R642[医药卫生—外科学] R655.3[医药卫生—临床医学]