地塞米松对VILI大白兔肺组织细胞凋亡的影响  

Influence of dexamethasone on the lung tissue cell apoptosis in rabbits with VILI

作　　者：刘伯毅[1] 郑晓丽[1] 郑翔[1] 方志成[1] 刘培[1] 

机构地区：[1]湖北医药学院附属太和医院重症医学科,湖北十堰442000

出　　处：《海南医学》2013年第8期1099-1101,共3页Hainan Medical Journal

基　　金：十堰市科技攻关项目(编号:200945D)

摘　　要：目的探讨地塞米松对呼吸机相关性肺损伤(Ventilator induced lung injury,VILI)大白兔肺组织细胞凋亡的影响。方法将30只健康雄性大白兔随机分成三组(每组各10只):对照组(Ⅰ组):插管后不行机械通气,静脉注射生理盐水5ml;大潮气量机械通气组(Ⅱ组)及地塞米松干预组(Ⅲ组):插管后机械通气(潮气量为25ml/kg。频率为30次/min;吸呼比为1:3,FiO2为21%,PEEP为0cmH2O,通气时间:24h);Ⅱ组:开始机械通气时静脉注射生理盐水5ml;Ⅲ组:静脉注射地塞米松5mg/kg,用生理盐水稀释至5ml。Annexin-V/PI双染方法进行肺组织细胞凋亡检测、测定肺组织湿/干重(W/D)值、制备肺组织石蜡切片,在显微镜下观察肺组织病理学变化。结果Ⅱ组、Ⅲ组肺组织细胞凋亡率及W/D较Ⅰ组对比显著升高(P<0.001),同时,Ⅲ组肺组织细胞凋亡率及W/D较Ⅱ组明显降低(P<0.01)。肺组织病理切片:Ⅱ组可见肺间质和肺泡腔水肿,肺内炎性细胞浸润;Ⅲ组较Ⅱ组肺水肿轻。结论在VILI模型中,地塞米松通过抑制肺组织细胞凋亡,从而防治VILI。Objective To explore the influence of dexamethasone on the lung tissue cell apoptosis in rabbits with VILI. Methods Thirty healthy male rabbits were randomly divided into three groups （10 rabbits in each group）： control group （group I ）, high tidal volume mechanical ventilation group （group II ） and dexamethasone group （group III）. Group I applied no mechanical ventilation after intubation, with intravenous injection of 5 ml physiological saline. Group II and group III were given mechanical ventilation （tidal volume： 25 ml/kg; frequency： 30 times/min, respiratory absorption ratio： 1：3; PEEP： 0 cmH2O; FiO3： 21%; ventilation Time： 24 h）. Group 1/ were injected intravenously with 5 ml physiological saline when starting mechanical ventilation. Group III were injected intravenously 5 mg/kg dexamethasone. Cell apoptosis in lung tissue was detected by means of annexin V/PI staining method. The wet and dry weight （W/D） ratio of lung tissue was calculated, and lung tissue sections were prepared for biopsies. Results Lung tissue cell apoptosis rate and W/D in group II, group HI was significantly higher that those in group I （P〈0.001）, which was significantly lower in group llI than group II （P〈0.01）. According to lung tissue biopsy, lung tissue visible pulmonary interstitial and alveolar spaceedema, pulmonary inflammatory cell infillration could be observed in group II, and the pulmonary edema was weaker in group III than group II. Conclusion Dexamethasone can inhibit cell apoptosis in lung tissue, thus prevention VILI.

关 键 词：地塞米松 机械通气 肺损伤 细胞凋亡 

分 类 号：R689[医药卫生—骨科学]