血红素氧合酶1干预对呼吸机所致肺损伤的影响  

Effects of Heme Oxygenase-1 Intervention on Ventilator-Induced Lung Injury

作　　者：安莉[1] 刘庆辉[1] 秦雪冰[1] 刘长庭[1] 俞森洋[1] 

机构地区：[1]解放军总医院南楼呼吸科,北京100853

出　　处：《中国呼吸与危重监护杂志》2010年第3期284-286,共3页Chinese Journal of Respiratory and Critical Care Medicine

基　　金：北京市自然科学基金项目(编号:7082088)

摘　　要：目的探讨血红素氧合酶1(HO-1)的干预对家兔呼吸机所致肺损伤(VILI)的影响。方法 24只家兔随机分为常规潮气量+PEEP组(C组)、呼吸机所致肺损伤组(VILI组)、呼吸机所致肺损伤+HO-1诱导剂干预组(Hm组);实验终点行动脉血气分析,Western blot和免疫组化方法检测肺组织HO-1的表达水平和细胞定位,观察肺组织形态变化并进行肺损伤评分,测定肺组织湿干重比值。结果 VILI组较C组HO-1蛋白表达水平升高,HO-1蛋白主要定位于肺泡上皮细胞和血管内皮细胞,在肺泡巨噬细胞和中性粒细胞也有表达。Hm组与VILI组比较,HO-1蛋白表达水平升高,PaO2/FiO2升高,肺湿干重比值和肺损伤评分降低,差异有统计学意义(P<0.05)。结论 HO-1蛋白表达升高能减轻VILI,对VILI有一定的保护作用。Objective To explore the expression and effect of heme oxygenase-1（HO-1） in ventilator-induced lung injury.Methods Twenty-four New Zealand rabbits were randomly assigned to three groups,ie.a conventional ventilation＋PEEP group（C group）,a ventilator-induced lung injury group（VILI group）,and a VILI＋HO-1 inducer hemin group（Hm group）.Western blot and immunohistochemistry assay were used to investigate the expression of HO-1 protein.Blood gas analysis,lung wet/dry ratio,lung histopathology and lung injury score were used to evaluate lung injury.Results HO-1 protein expression significantly increased in the VILI group compared with the C group.HO-1 was found mainly in alveolar epithelial cells and vascular endothelial cells,as well as in alveolar macrophages and neutrophils.Compared with the VILI group,HO-1 protein and PaO2/FiO2 increased,while lung wet/dry ratio and lung injury score decreased in the Hm group significantly（P0.05）.Conclusion High HO-1 expression can alleviate lung injury from large tidal volume ventilation,implying its protective role in lung pathogenesis.

关 键 词：呼吸机所致肺损伤 血红素氧合酶1 家兔 

分 类 号：R563[医药卫生—呼吸系统]