重度脑损伤误吸大鼠继发肺损伤的实验研究  

The experimental study on secondary lung injury by aspiration in severe brain injury rats

作　　者：权明桃[1] 江智霞[1] 任光阳[1] 施久军[1] 罗祎[1] 程华刚[2] 

机构地区：[1]遵义医学院附属医院ICU,遵义563003 [2]遵义医学院附属医院神经科,遵义563003

出　　处：《重庆医科大学学报》2011年第8期921-923,共3页Journal of Chongqing Medical University

基　　金：贵州省教育厅自然科学研究项目(编号:黔教科2008035);贵州省国际科技合作项目【编号:黔科合外G字(2009)700117号】

摘　　要：目的:探讨重度脑损伤误吸胃液致肺损伤的机制。方法:SD雄性大鼠50只,随机分为对照组(10只)和实验组(40只)。实验组采用改进型Marmarou模型方法致大鼠重度脑损伤,再经气管内滴入胃液,制作重度脑损伤误吸模型。分别在造模后2、6、24和48 h各处死10只大鼠收集标本,采用酶联免疫吸附试验(Enzyme linked immunosorbent assay,ELISA)法检测大鼠血浆中性粒细胞弹性蛋白酶(Neutrophil elastase,NE)含量、支气管肺泡灌洗液(Bronchoalveolar lavage fluid,BALF)中NE和白介素-8(Interleukin-8,IL-8)含量;免疫透射比浊法测定BALF中白蛋白浓度;光学显微镜观察肺组织病理改变情况。结果:实验组BALF和血浆中NE含量2 h开始升高,与对照组比较差异有统计学意义(P<0.05)。BALF中NE升高幅度较血浆明显;BALF中IL-8含量在2h开始升高,同时BALF中白蛋白浓度也明显升高(P<0.05);BALF中NE、IL-8与白蛋白浓度呈正相关(P<0.01)。结论:重度脑损伤误吸可造成肺组织的炎症反应,NE、IL-8参与肺内炎性反应,造成肺组织损伤。Objective：To investigate gastric aspiration induced lung injury in severe brain injury.Methods：50 male SD rats were randomly divided into control group（n=10） and experimental group（n=40）.The severe brain injury in experimental group was made by an improved method of Marmarou model,and then the aspiration models were made by intratracheal instillation of gastric juice.Each ten rats were killed to collect samples at 2 h,6 h,24 h and 48 h separately after the models were made.Plasma neutrophil elastase（Neutrophil Elastase,NE） content,the NE content and interleukin-8（IL-8） content in bronchoalveolar lavage fluid（BALF） were detected by using enzyme-linked immunosorbent assay（ELISA）;immune turbidimetric determination was used for the albumin concentration in BALF;and optical microscope for pathological changes in lung tissue.Results：BALF and plasma NE levels began to increase at 2 h,which was significant compared with the control group（P0.05）.NE in BALF increased at a significantly higher rate than in plasma;IL-8 level in BALF began to increase at 2h,and meanwhile,BALF albumin concentration was significantly increased（P0.05）;NE,IL-8 in BALF and albumin concentration had positive correlation（P0.01）.Conclusion：Aspiration after severe brain injury can cause inflammation in lung tissue,and NE and IL-8 take part in pulmonary inflammatory response,resulting in lung injury.

关 键 词：重度脑损伤 急性肺损伤 中性粒细胞弹性蛋白酶 

分 类 号：R651.1[医药卫生—外科学]