Clara细胞在兔肺缺血再灌注损伤中的作用  

Role of Clara cells in lung ischemia-reperfusion injury in rabbits

作　　者：李戈辉[1] 李李[1] 沈金美[1] 裴万敏[2] 

机构地区：[1]中南大学湘雅二医院麻醉科,长沙市410011 [2]湖南省人民医院麻醉科

出　　处：《中华麻醉学杂志》2010年第3期372-375,共4页Chinese Journal of Anesthesiology

基　　金：湖南省自然科学基金（08JJ5019）

摘　　要：目的 探讨Clara细胞在兔肺缺血再灌注（IR）损伤中的作用.方法 健康家兔24只.随机分为3组（n=8）：假手术组（S组）、IR组、肺Clara细胞剥除＋IR组（CIR组）.CIR组置于萘气体浓度为89.28 mg/m^2的气体箱中12 h,S组和IR组置于无萘气体箱中12 h.取出正常饲养24 h后.IR组和CIR组采用阻断左肺门60 min,再灌注120 min的方法制备肺IR模型,S组不予阻断肺门.于再灌注120 min时采集颈动脉血样5 ml,测定血清TNF-α和总蛋白浓度,收集支气管肺泡灌洗液（BALF）,计数WBC、中性粒细胞（PMN）,计算PMN百分比,取肺组织测定MDA含量和湿/干重比值（W/D比值）,观察病理学改变和Clara细胞的分布情况.结果 S组肺泡完整,肺实质无炎性细胞浸润,可见较多的Clara细胞;IR组肺不张伴肺气肿,肺间质增宽水肿,中度炎性细胞浸润,肺泡腔内有淡黄色渗出,渗出物有WBC,亦可见较多的Clara细胞;CIR组炎性细胞浸润严重,肺泡腔内渗出物多.WBC较多,血管腔变窄,甚至出现无复流现象,Clara细胞少见.与S组比较,IR组和CIR组BALF中WBC计数、PMN百分比、血清TNF-α浓度、肺组织MDA含量及W/D比值升高（P〈0.05 ）;与IR组比较,CIR组BALF中WBC计数、PMN百分比、血清TNF-α浓度、肺组织MDA含量及W/D比值升高（P＜0.05）.结论 肺IR损伤时兔肺内Clara细胞通过抑制炎性反应产生内源性的保护作用.Objective To investigate the role of Clara cells in lung ischemia-reperfusion （I/R） injury in rabbits. Methods Twenty-four healthy 10-12 month old rabbits of either sex weighing 1.5-2.0 kg were randomly divided into 3 groups （n = 8 each） ; group A sham operation （group S） ; group B lung I/R and group C Clara cell elimination ＋ lung I/R. The animals were anesthetized with iv pentobarbital 50 mg/kg , tracheostomized and mechanically ventilated. In group B and C lung I/R was induced by clamping the left hilum of lung for 60 min followed by 120 min reperfusion. In group C Clara cells were eliminated by ventilating the lungs with 89.28 mg/m^2 naphthalin vapor for 12 h before lung I/R. The animals were killed by iv KCl at the end of 120 min reperfusion after lung ischemia. The left lung was immediately removed for microscopic examination, determination of W/D lung weight ratio and serum TNF-α level and MDA content. The percentage of neutrophil in bronchoalveolar lavage fluid （BALF） was detected as index of lung injury. The expression of Clara cell secreting protein （CCSP） in the lung was detected by immuno-histochemistry to indicate the number and distribution of Clara cells in the lung. Results Microscopic examination showed that there were severe leukocyte infiltration in alveolar spaces, alveolar edema and destroyed alveolar structure in group B and C. The serum TNF-α level,W/D ratio and MDA content in the left lung and neutrophil percentage and WBC counts in BALF were significantly higher in group C than in group B. Conclusion Clara cells can protect the lungs against I/R injury through inhibiting inflammatory responses.

关 键 词：再灌注损伤 肺 CLARA细胞 炎症 

分 类 号：R285.5[医药卫生—中药学]