还原型谷胱甘肽对大鼠呼吸机相关性肺损伤的保护作用  

The protective effects of reduced glutathione on ventilator-induced lung injury in rats

作　　者：胡乃浩[1] 赵文静[2] 

机构地区：[1]射阳县人民医院麻醉科,江苏射阳224300 [2]徐州医学院附属医院ICU,江苏徐州221002

出　　处：《徐州医学院学报》2010年第1期14-18,共5页Acta Academiae Medicinae Xuzhou

基　　金：江苏省科技厅社会发展基金(BS2005019)

摘　　要：目的研究还原型谷胱甘肽(GSH)对大鼠呼吸机相关性肺损伤(VILI)的保护作用。方法24只健康雄性SD大鼠随机分为3组(每组n=8),A组为自主呼吸组;B组为大潮气量机械通气组;C组为大潮气量机械通气加GSH处理组。B、C 2组呼吸参数:潮气量(VT)=30 m l/kg、频率(P)为40次/m in、通气时间为4 h。每小时行1次动脉血气分析,计算氧合指数(PaO2/F iO2)。实验完毕收集肺组织和肺灌洗液标本。光镜观察肺组织病理形态改变,免疫组化检测Fas/FasL蛋白,检测肺湿/干重比(W/D)、肺组织丙二醛(MDA)、超氧化物歧化酶(SOD)、肺灌洗液中白细胞计数、肿瘤坏死因子(TNF-α)和蛋白总量。结果和A组比较,B组肺组织病理学改变明显,Fas/FasL蛋白增加,W/D、白细胞计数(WBC)、TNF-α、MDA等指标升高,而SOD及通气3 h以后PaO2/F iO2下降;和B组比较,C组肺组织病理学改变明显减轻,Fas/FasL蛋白质量减少,W/D、WBC、TNF-α、MDA等指标降低,SOD、PaO2/F iO2上升。结论GSH对VILI有一定的保护作用。Objective To investigate the protective effects of reduced glutathione on ventilator-induced lung injury（VILI） in rats.Methods 24 male Sprague-Dawley rats were randomly divided into 3 groups（n=8 each）： group A received room air without mechanical ventilation;group B received mechanical ventilation of large tidal volume（VT） with room air;group C was treated with mechanical ventilation of large tidal volume with room air plus reduced glutathione.The set parameters of mechanical ventilation in groups B and C： VT=30 ml/kg,breathing rate=40 times/min,and time of ventilation=4 h.Arterial blood gases were measured hourly to calculate oxygenation index（PaO2/FiO2）.Rats were sacrificed and the lung lavage liquid and lung tissue were collected and stored with correct methods.The measured indexes including total protein,WBCs and TNF-α in bronchoalveolar lavage fluid（BALF）,wet-to-dry weight ratio（W/D） of lung,malondialdehyde（MDA） and superoxide dismutase（SOD） levels in the lung were assayed,respectively.Lung pathological changes and the expressions of Fas/FasL proteins were observed by microscopy.Results Compared with group A,total protein,W/D,WBCs,TNF-α,MDA and the expression of Fas/FasL proteins significantly increased in group B,while the levels of SOD,and PaO2/FiO2 at 3 h after ventilation significantly decreased.Compared with group B,total protein,W/D,WBCs,TNF-α,MDA and expressions of Fas/FasL proteins decreased in group C,and the levels of SOD and PaO2/FiO2 increased.Conclusion Reduced glutathione has certain protective effect on ventilator-induced lung injury.

关 键 词：呼吸机相关性肺损伤 机械通气 还原型谷胱甘肽 

分 类 号：R563[医药卫生—呼吸系统]