不同潮气量机械通气对大鼠肺组织Clara细胞分泌蛋白及分泌型磷脂酶A2的影响  

Effects of different tidal volume ventilation on clara cell secretory protein and secretory phosphlipase A2 in lungs of rat

作　　者：李军[1] 王晓艳[1] 张新日[1] 

机构地区：[1]山西医科大学第一医院呼吸科,太原030001

出　　处：《国际呼吸杂志》2012年第9期689-692,共4页International Journal of Respiration

基　　金：山西省科技攻关资助项目（2007032016-1）;太原市科技资助项目（0801041）

摘　　要：目的通过观察不同潮气量机械通气大鼠肺组织Clara细胞分泌蛋白（CC16）及分泌型磷脂酶A2（sPLA2）的表达，探讨CC16和sPLA：在呼吸机所致肺损伤（VILI）发生中的作用。方法24只雄性Wistar大鼠随机分为对照组、小潮气量组和大潮气量组，测定各组大鼠支气管肺泡灌洗液（BALF）总蛋白含量及中性粒细胞计数，采用免疫组织化学染色法检测肺组织Clara细胞计数和CC16蛋白表达，采用逆转录聚合酶链反应法检测肺组织sPLAzmRNA的表达。结果大潮气量组大鼠BALF总蛋白含量、中性粒细胞的计数和肺组织sPLA2 mRNA表达水平均明显高于对照组和小潮气量组（P值均〈0．01），而肺组织Clara细胞计数和CC16蛋白表达水平则明显低于对照组和小潮气量组（P值均〈0．01）；小潮气量组各项指标与对照组比较差异无统计学意义（P〉0．05）。结论大潮气量机械通气通过诱导肺组织sPLA2 mRNA高表达，使Clara细胞合成及分泌CC16减少，导致肺组织炎症反应扩大，可能是VILI发生的重要因素之一。Objective To investigate the effects of clara cell secretory protein （CC16） and secretory phospholipase A2 （sPLA2） on ventilator induced lung injury （VILI） by observing their expressing in lungs of rats with different tidal volume ventilation. Methods 24 health Wistar rats were divided into three groups：control group, low tidal volume group and high tidal volume group. The total protein （TP）and polymorphonuclear cells （PMN） in bronchoalveolar lavage fluid （BALF） were measured. The expression of sPLA2 mRNA in lung tissues was detected by reverse transcription polymerase chain reaction （RT-PCR）. The number of Clara ceils and the expression of CC16 in lung tissues were detected by immunohistochemistry. Results The level of TP and PMN in BALF and the expression of sPLA2 mRNA in lung tissues in control and low tidal volume groups were increased significantly than that in high tidal volume group （ P 〈0.01）. The number of Clara cells and the expression of CC16 n lung tissues in control and low tidal volume groups were decreased significantly than that in high tidal volume group （ P 〈0.01）. There were no statistic differences existed between the low tidal volume group and control group （ P 〉0.05）. Conclusions Over expression of sPLA2 mRNA induced by high tidal volume ventilation caused Clara cells decreasing and CC16 low expressing which lead to lung tissue inflammation aggravated may be one of the important factors giving rise to VILI.

关 键 词：机械通气 急性肺损伤 CLARA细胞分泌蛋白 分泌型磷脂酶A2 

分 类 号：R563.8[医药卫生—呼吸系统]