溴环己胺醇对通气机导致肺损伤保护作用的研究  

Prophylaxis against ventilator induced lung injury by Ambroxol

作　　者：张波[1] 刘又宁[1] 

机构地区：[1]中国人民解放军总医院呼吸科,北京100853

出　　处：《中华医学杂志》2000年第1期51-53,共3页National Medical Journal of China

摘　　要：目的　探讨抗氧化剂溴环己胺醇对通气机导致肺损伤 (VILI)的保护作用。方法　将 3 0只健康大鼠随机分为 3组 ,A组为对照组 (常规机械通气 ) ,B组为大潮气量通气组 ,C组为大潮气量加溴环己胺醇干预组 ,分别检测VILI大鼠肺灌洗液 (BALF)中蛋白质、白细胞、肿瘤坏死因子α(TNF α)、白细胞介素 1β(IL 1β)、白细胞介素 8(IL 8)以及肺匀浆中丙二醛 (MDA)、超氧化物歧化酶 (SOD)、谷胱甘肽 (GSH)的含量 ,并观察光镜下动物肺损伤的程度。结果　 ( 1)B组大鼠肺泡腔内白蛋白及总蛋白含量均显著高于A组及C组 ,C组BALF中WBC总数较B组明显减少 ,蛋白质含量亦显著降低 ;( 2 )B组大鼠肺脏局部TNF α、IL 1β、IL 8细胞因子含量分别为 10 1 6pmol·L-1·mg-1Pr± 3 7 4pmol·L-1·mg-1Pr,0 4 7μg·L-1·mg-1Pr± 0 14 μg·L-1·mg-1Pr和 2 0 2 μg·L-1·mg-1Pr± 0 4 9μg·L-1·mg-1Pr,与A组比差异均有显著意义 (P <0 0 5 ) ;B组大鼠肺匀浆中MDA含量显著增多 ,而SOD含量却明显降低 ,与A组比较差异均有显著性意义 (P <0 0 0 1)。溴环己胺醇可显著降低肺脏局部TNF α的产生 ,C组BALF中TNFα含量为 64 3pmol·L-1·mg-1Pr± 17 4pmol·L-1·mg-1Pr,显著低于A组。此外 ,溴环己胺醇还可明显抑制VILI大鼠肺脏局?Objective ToinvestigatetheprotectiveeffectofAmbroxolonventilatorinducedlunginjury (VILI)ofrats Methods 3 0healthySDratswererandomlydividedintothreegroups :groupAwasservedas controlgroup (n =10 ,VT8ml/kg) ,groupBreceivedlargeVTventilation (n =10 ,VT4 0ml/kg) ,groupC receivedlargeVTventilationwithpre treamentofIPambroxol Thecontentsofprotein ,TNF α ,IL1 β ,IL 8in BALFandMDA ,SOD ,GSHlevelsinthehomogenateoftheratlungswereassayedrespectively .Totalwhiteblood cellsinBALFwerecounted ;Theseveritiesoflunginjuryofthethreegroupswereassessedunderalight microscope Results ThealbuminandtotalproteincontentsinBALFweresignificantlyhighergroupAthanin groupsBandC .AlargequantityofWBCsinfiltrationwerefoundinBALFofgroupB ,whiletheamountofWBCs weredecreasedingroupC .TNF α ,IL 1βandIL 8levelinBALFofgroupBwere 10 1 6pmol·L-1·mg-1Pr± 3 7 4pmol·L-1·mg-1Pr,0 4 7μg·L-1·mg-1Pr± 0 14 μg·L-1·mg-1Prand 2 0 2 μg·L-1·mg-1Pr± 0 4 9μg ·L-1·mg-1Pr ,respectively MDA ,oneoftheparametersreflectingtheextentofoxidativereaction ,were producedprofoundlyinthelungsofgroupB ,butthelocallevelsofSOD ,whichreflectstheabilityof antioxidation ,weredecreasedsignificantlyingroupB Thereexistedsignificantdifferencesoftheaboveparameters betweengroupBandgroupA .AmbroxolcouldsignificantlydecreasethelocallyproducedTNF αandinhibitthe oxidativereactions ,andincreasethelocallyantioxidativepotency Severeacutelunginjuriesweredetectedin groupAbyhistologicalexaminationandtheextentofinjurywasmuchlighteringroupCthaningroupB Conclusion Locallyincreasedinflammatorycytokinesformationandtheimbalancedoxidative/antioxidative reactionplayimportantrolesinthepathogenesisofVILI.AmbroxolhasanobviousprotectiveeffectonVILIthrough itsantioxidant/anti inflammationpotent

关 键 词：机械通气 通气机 肺损伤 溴环己胺醇 保护作用 

分 类 号：R563.9[医药卫生—呼吸系统]