热烟雾吸入性损伤肺组织水肿与肿瘤坏死因子-α水平的相关性分析研究  

Correlation between pulmonary edema and tumor necrosis factor-α in hot smoke inhalation injury： experiment with rats

作　　者：宋建奇[1] 樊毫军[1] 侯世科[1] 董文龙[1] 

机构地区：[1]中国人民武装警察部队总医院医务部,北京100039

出　　处：《中国急救复苏与灾害医学杂志》2011年第6期510-513,共4页China Journal of Emergency Resuscitation and Disaster Medicine

基　　金：武警总部级课题（WJAQ2010-08）

摘　　要：目的 探索热烟雾吸入性损伤肺组织水肿是否与肿瘤坏死因子（TNF）-α水平增高有关.方法 将48只Wistar大鼠随机分为正常对照组（12只）以及热烟雾吸入性损伤后2 h、4 h、8 h模型组（各12只）.正常对照组在8 h之后活杀,模型组动物分别于致伤后2 h,4 h,8 h活杀.比较各组动物肺组织病理学改变,动脉血气指标（PaO2、PaCO2、pH）,肺水肿程度[肺含水量湿重/干重比（W/D）],血液和支气管肺泡灌洗液（BLAF）中炎症因子水平（肿瘤坏死因子-α浓度）.结果 正常对照组肺组织病理无明显改变,热烟雾吸入性损伤模型组肺组织表现肺泡间隔增宽,大量白细胞渗出、聚集,部分肺泡萎陷不张,肺泡腔可见渗出液、红细胞.模型组动脉血pH和PaO2均随时间推移而下降,且均显著低于对照组（均P〈0.01）;但PaCO2于损伤后各时间点均显著高于正常对照组（均P〈0.01）.模型组各时间点BALF和血清中的TNF-α,以及肺组织的W/D均随时间推移而升高,且均显著高于正常对照组（均P〈0.01）.模型组血和BALF中的TNF-α浓度增高与肺组织W/D值增高呈直线相关（均P〈0.01）.结论 热烟雾吸入性损伤肺组织水肿与TNF-α水平增高有关.Objective To explore the correlation between puhnonary edema and tumor necrosis factor （TNF）-α in hot smoke inhalation injury. Methods 48 Wistar rats were randomly divided into normal control group （n=12） and hot smoke inhalation injury models group （n=36）. The rats in the normal control group were killed 8 hours later. The rats of the model group underwent hot somke inhalation injury and were killed 2 h, 4 h, and 8 h after injury respectively, with 12 rats in each subgroup. Pathological examination of the lung was conducted, and the wet/dry （W/D） lung weight ratio was calculated. Arterial blood samples were collected for analyses of blood gases and pH. The tumor necrosis factor alpha （TNF-a） levels in serum and bronchoalveolar lavage fluid （BALF） were tested. Linear correlation analysis was used to analyze the correlation between pulmonary edema and tumor TNF-α. Results Pathology showed thickened alveolar septae , inflammatory cells effusion, alveolus detelectasis, and extravasate and red ceils in the alveolar space. The levels of blood pH decreased with the passing of time, both significantly lower than those of the control group （both P〈0.01）, however, the PaCO2 levels at the 3 time points after injury were all significantly higher than those of the control group （all P〈0.01）. The TNF-α in blood and BALF sample and W/D level of the model group all increased with the passing time, all significantly higher than those of the control group （all P〈0.01）. The correlation coefficients between W/D ratio and TNF-α in serum and BALF were 0.855 and 0.823 respectively （both P〈 0.01）, showing a linear correlation. Conclusion The pulmonary edema degree is correlated with the TNF-α level in hot smoke inhalation injury.

关 键 词：热烟雾吸入性损伤 TNF-Α 肺水肿 

分 类 号：R563.9[医药卫生—呼吸系统]