Toll样受体3和4在大鼠呼吸机相关肺损伤肺组织中的表达  

Expression of Toll-like receptor 3 and 4 in the lung tissue of rats with ventilator-induced lung injury

作　　者：朱珊[1] 潘灵辉[1] 林飞[1] 赵琼[1] 魏癑 

机构地区：[1]广西医科大学附属肿瘤医院麻醉科,南宁市530021

出　　处：《临床麻醉学杂志》2013年第6期594-597,共4页Journal of Clinical Anesthesiology

基　　金：国家自然科学基金(81060008)

摘　　要：目的研究不同潮气量(VT)及不同通气时间对呼吸机相关肺损伤(VILI)的大鼠肺组织Toll样受体(TLR)3和4表达的影响。方法 120只SD大鼠随机均分为自主呼吸组(A组)、VT=10ml/kg组(B组)、VT=20ml/kg组(C组)及VT=40ml/kg组(D组)。所有大鼠行经口气管插管,A组插管后保持自主呼吸,B、C、D组用动物呼吸机予双肺机械通气。分别于通气60、120和240min时每组大鼠各取10只行颈总动脉放血处死,取各组肺组织进行HE染色并根据肺损伤评分标准对各组肺组织评价病理学改变;采用RT-PCR检测TLR3mRNA、TLR4mRNA表达。ELISA检测TLR3、TLR4蛋白的浓度。结果通气240min后,A组肺组织正常;B组可见少许炎性细胞浸润;C组可见肺间隔增宽,部分炎性细胞浸润;D组可见肺组织点状或者片状出血,肺间隔增宽,肺间质明显水肿,肺泡腔融合,大量炎性细胞积聚,部分肺组织有实变。通气60、120和240min时,C、D两组肺组织病理评分明显大于A、B组(P<0.05),D组明显大于C组(P<0.05);C、D组TLR3、TLR4和TLR3mRNA、TLR4mRNA表达明显高于A、B两组(P<0.05或P<0.01),D组明显高于C组(P<0.05或P<0.01),四组不同通气时间的TLR3、TLR4和TLR3mRNA、TLR4mRNA表达差异无统计学意义。结论大潮气量通气导致肺组织TLR3、TLR4的表达上调,TLR3、TLR4的表达与肺组织损伤有相关性。Objective To investigate the tidal volume （VT） and different ventilation time on expression of Toll-like receptor（TLR）3 and 4 in the rat model of ventilator-induced lung injury （VILI）. Methods One hundred and twenty SD rats were randomly divided into four groups： spontaneous breathing group （group A）, and groups B, C and D receiving the tidal volume at 10 ml/ kg,20 ml/kg and 40 ml/kg, respectively. All groups were inserted tracheal catheter via mouth. Group A was spontaneously breathing after inserted tracheal catheter. Groups B, C, D was ventilated to two lung. After the experiment, 10 rats in each group were sacrificed after carotid artery bloodletting 60,120 and 240 min after ventilation. The lung tissues were stained with HE. The pathological changes of lung tissues were evaluated according to lung injury scoring criteria. Expression of TLR3rnRNA and TLR4mRNA was tested by RT-PCR, and concentration of TLR3, TLR4 with ELISA. Results Four hours after ventilation, group A was normal, group B showed little inflammatory cell infiltration, lung interval was broadened with a little inflamn^tory cell infiltration in group C, while punetate hemorrhage, lung interval widened, interstitial lung edema, alveolar space fusion, accumulation of a large number of inflatrmtory ceils, the partial hmg tissue consolidatiun were seen in group D. 60, 120 and 240 min after ventilation, the lung histopathology score in groups C, D was significantly higher than in groups A and B（P〈0. 05）. The score in group D was significantly greater than in group C（P〈0. 05）. The expression of TLR3,TLR4,TLR3 mRNA and TLR4mRNA in groups C,D was significantly higher than that in groups A, B（P〈0. 05 or P〈0. 01）. The expression of TLR3,TLR4,TLR3 mRNA and TLR4 mRNA in group D was significantly higher than that in group C （P 〈 0. 05 or P〈 0.01）. The expression of TLR3mRNA and TLR4mRNA in each subgroup with different ventilation time showed no statistical significant. Conclusion Hyperventilation tidal volume cou

关 键 词：呼吸机相关肺损伤 机械通气 TOLL样受体3 TOLL样受体4 

分 类 号：R563.8[医药卫生—呼吸系统]