不同潮气量机械通气对兔肺组织转化生长因子-β_1的影响  

Effects of Mechanical Ventilation at Different Tidal Volumes on Expression of TGF-β1 in Lung of Rabbits

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,湖北省十堰市442000

出　　处：《中华全科医学》2013年第5期669-670,F0003,共3页Chinese Journal of General Practice

基　　金：湖北省十堰市科技攻关项目(2009045D)

摘　　要：目的比较不同潮气量(tidal volume,VT)机械通气对大白兔肺组织转化生长因子-β1(transforming growthfactor-β1,TGF-β1)的影响,探讨TGF-β1在呼吸机相关性肺损伤(ventilator associated lung injury,VALI)中的作用。方法将30只健康雄性大白兔随机分成3组,每组各10只。对照组:插管后不进行机械通气,其它组插管后机械通气。小潮气量组(L-VT):VT8ml/kg,大潮气量组(H-VT):VT25ml/kg,其它参数相同。通气24h。观察实验前后观察指标:动脉血氧分压(PaO2)、肺组织TNF-α、TGF-β1、湿/干重(W/D)值、肺组织病理学变化。结果 H-VT组:实验12h后动脉血PaO2降低(P<0.05),实验结束后肺组织W/D、TNF-α、TGF-β1升高(P<0.01),肺组织病理病理切片可见肺组织水肿。L-VT组:相应指标无显著变化(P>0.05)。结论大潮气量机械通气发生了VALI,肺组织TGF-β1升高,表明TGF-β1在VALI发病机制中起重要作用。Objective To explore the effects of mechanical ventilation at different tidal volumes on the expression of transforming growth factor-β1 （ TGF-β1 ） in the Lung of rabbits, and to explore the role of TGF-β1 in ventilator associated lung injury（ VA- LI）. Methods Total 30 healthy male rabbits were randomly divided into three groups（ 10 rabbits in each group） ： control group （without mechanical ventilation after intubation）, low tidal volume group （L-VT group） ：VT：8 ml/kg, for 24 h, and high tidal volume group （ H-VT group） ： VT ：25 mL/kg, for 24 h, Other parameters are the same. The observation index included： PaO2,1evels of TNF-α and TGF-β1 in lung tissues, W/D ratio of lung tissue, and histopathological changes of lung tissue. Results H-VT group： PaO2 were decreased after 12 h （ P 〈 0.05 ）, W/D, TNF-α and TGF-v1 increased （ P 〈 0.01 ）. Lung tissue edema could be fined in lung tissue biopsy of lung injured group. L-Vr group： no significant change of corresponding indicators were found （P 〉 0.05 ）. Conclusion High tidal volume ventilator produced VALI, the level of TGF-β1 were increased. TGF-β1 may play an important role in the occurrence and development of VALI.

关 键 词：机械通气 肺损伤 TGF—β1 机制 

分 类 号：R563[医药卫生—呼吸系统] R349.5[医药卫生—内科学]