高渗盐溶液对兔肠缺血/再灌注所致肺损伤的保护作用  

Protective Effect of Hypertonic Saline Solution on Lung Injury Induced by Intestinal Ischemia-reperfusion in Rabbits

作　　者：徐军[1] 郑亮亮[1] 刘业成[1] 李毅[1] 朱华栋[1] 郭树彬[1] 于学忠[1] 马遂[1] 

机构地区：[1]中国医学科学院 北京协和医学院 北京协和医院急诊科,北京100730

出　　处：《协和医学杂志》2013年第3期255-259,共5页Medical Journal of Peking Union Medical College Hospital

摘　　要：目的探讨高渗盐溶液(hypertonic saline solution,HS)对肠缺血/再灌注(intestinal ischemia-reperfusion,IIR)所致肺损伤的作用。方法 72只新西兰白兔按随机数字表法分为4组(n=18):空白对照组、IIR组、4%HS治疗组、7.5%HS治疗组。空白对照组采用仅开腹、游离但不阻断肠系膜上动脉的假手术处理;其余实验组采用完全夹闭肠系膜上动脉1h后开放再灌注的方法制备IIR模型,2个治疗组均在肠系膜上动脉开放前5min输注相应浓度的氯化钠溶液。选择缺血前与再灌注后2、4、6h4个时间点取血测定各组肿瘤坏死因子-α(tumor necrosis factor-α,TNF-α)和白细胞介素-10(interleukin-10,IL-10)水平。再灌注后6h每组处死8只动物,取其肺组织测定组织中的髓过氧化物酶(myeloperoxidase,MPO)活性、肺组织湿/干比,光镜下观察病理形态改变。结果 IIR组再灌注后循环中TNF-α和IL-10水平、肺组织MPO活性、肺组织湿/干比以及病理损伤评分均较空白对照组显著升高(P<0.05);2个HS治疗组与IIR组相比,循环中TNF-α和IL-10水平、肺组织MPO活性、肺组织湿/干比以及病理损伤评分均显著下降(P<0.05);而7.5%HS组在4%HS组基础上各指标进一步下降(P<0.05)。结论 HS治疗对IIR所致肺损伤具有保护作用,该效应在一定范围内随着浓度的增加而增强。Objective To study the effect of hypertonic saline solution （ HS） on lung function in intesti-nal ischemia-reperfusion （IIR） models. Methods Totally 72 rabbits were randomly divided into 4 groups （ n =18） ： control group, IIR group, 4% HS group, and 7. 5% HS group. The IIR models were produced by clampingsuper mesenteric artery （ SMA） for 1 hour and declamping SMA for 6 hours in IIR group, 4% HS group, and7. 5% HS group, whereas animals in control group underwent sham operation. The corresponding sodium chloridesolution was infused in the 2 treatment groups in 5 minutes before declamping SMA. Before and 2,4,6 hours af-ter IIR, the plasma levels of tumor necrosis factor-α （TNF-α） and interleukin-10 （IL-10） were measured. At 6hours after IIR, 8 rabbits in each group were killed to measure the levels of lung water and myeloperoxidase（MPO） activity in lung tissue. Meanwhile, lung morphological changes were observed under light microscope. Results The plasma TNF-α and IL-10 levels, the levels of lung water and MPO activity in lung tissue, and lungmorphological score significantly increased in IIR group when compared with the control group （ P 〈 0. 05 ）. Compared with the IIR group, the TNF-α levels in plasma, the levels of lung water and MPO activity in lung tissue ,and lung morphological score in both two HS groups significantly decreased （ P 〈 0. 05 ） , particularly in7. 5% HS group which was significantly lower than those in the 4% HS group （P 〈 0. 05）. Conclusions HS hasa protective effect on the lung function during IIR. Such a protective effect increases along with the increase of HSconcentration within certain range.

关 键 词：肠缺血 再灌注 高渗盐溶液 急性呼吸窘迫综合征 

分 类 号：R363.2[医药卫生—病理学]