早期小剂量地塞米松对胸部开放伤后海水浸泡致犬急性肺损伤的影响  

Early treatment with small dose dexamethasone attenuates seawater immersion-induced acute lung injury in dogs with open chest trauma

作　　者：胡晓红[1] 李毅[2] 薛志强[3] 韩志海[2] 段蕴铀[2] 

机构地区：[1]海军总医院儿科,北京100048 [2]海军总医院呼吸科,北京100048 [3]解放军总医院胸外科,北京100853

出　　处：《第二军医大学学报》2009年第12期1358-1362,共5页Academic Journal of Second Military Medical University

基　　金：海军后勤科研计划课题(04-3304)~~

摘　　要：目的:观察早期使用地塞米松对胸部开放伤合并海水浸泡致急性肺损伤的影响。方法:24只健康成年杂交犬随机分成对照组、海水组和地塞米松治疗组。观察胸部开放伤后0、2、4、6、8 h的血浆渗透压、肺泡通透指数(支气管肺泡灌洗液内蛋白含量/血浆总蛋白含量)和外周血中白细胞计数的变化;采用ELISA试剂盒检测炎症因子IL-1β、IL-8、vWF等的表达变化;H-E染色观察各组肺脏的病理改变。结果:与海水组相比,地塞米松组肺组织病理改变减轻。血浆渗透压变化差异无统计学意义(P>0.05),肺泡通透指数降低(0.039±0.006vs0.055±0.002),差异有统计学意义(P<0.05)。外周血白细胞(WBC)计数(×109)和IL-1β、IL-8、vWF等炎症因子(pg/ml)水平明显减低(WBC计数:21.52±3.21vs24.81±2.08;IL-1β:72.84±38.42vs131.90±35.39;IL-8:45.21±16.39vs88.26±6.66;vWF:0.47±0.08vs1.03±0.09),差异均有统计学意义(P<0.05)。结论:早期应用地塞米松可减轻胸部开放伤后海水浸泡致犬急性肺损伤的炎症反应,延长救治时机。Objective：To investigate the effect of early dexamethasone treatment on seawater immersion-induced acute lung injury after open chest trauma.Methods： Twenty-four animals were evenly randomized into three groups： control group（CG）,seawater group（SG）,and dexamethasone treatment group（DG）.Animals in CG group only had open chest trauma,those in the SG group were exposed to seawater after open chest trauma,and those in the DG group were treated with dexamethasone（1 mg/kg） after exposed to seawater.The vital signs of animals,plasma osmotic pressure,lung permeability index（LPI）,and peripheral white blood cell count were observed 0,2,4,6,and 8 h after trauma.The plasma samples and bronchoalveolar lavage fluid（BALF） were collected for testing the levels of cytokines（IL-1β,IL-8,and vWF,etc.） with ELISA kit.H-E staining was used to observe the pathological changes of the lung.Results： Compared with the SG group,the pathological changes were improved in the DG group;the plasma osmotic pressures were similar between the two groups;and the pulmonary permeability index was markedly decreased in the DG group（0.039±0.006 vs 0.055±0.002,P〈0.05）.Besides,the count of peripheral leukocyte（×10^9） and plasma IL-1β,IL-8,and vWF（pg/ml） were all markedly decreased in the DG group compared with the SG group（WBC： 21.52±3.21 vs 24.81±2.08;IL-1β：72.84±38.42 vs 131.90±35.39;IL-8：45.21±16.39 vs 88.26±6.66;vWF：0.47±0.08 vs 1.03±0.09,P〈0.05）.Conclusion： Early dexamethasone treatment can attenuate the inflammatory injury of the lung in dogs with open chest trauma after seawater immersion,providing more chance for further management.

关 键 词：地塞米松 急性肺损伤 胸部开放伤 海水 浸泡 炎症因子 

分 类 号：R563[医药卫生—呼吸系统]