高频振荡通气联合骨髓间充质干细胞移植对急性呼吸窘迫综合征保护作用的实验研究  

Experimental study of high frequency oscillatory ventilation combined with bone marrow mesenchymal stem cells transplantation for the prevention of acute respiratory distress syndrome

作　　者：彭珊珊[1] 淦鑫[1] 钟良英[2] 郭光华[1] 

机构地区：[1]南昌大学第一附属医院呼吸科,江西南昌330006 [2]中山大学附属第一医院检验科,广东广州510080

出　　处：《中国急救医学》2013年第11期1025-1028,I0001,共5页Chinese Journal of Critical Care Medicine

基　　金：江西省自然科学基金项目（2010GZY0355）

摘　　要：目的 探讨高频振荡通气（HFOV）联合骨髓间充质干细胞（MSCs）对内毒素诱发急性呼吸窘迫综合征（ARDS）模型兔的保护作用.方法 家兔34只,2只用于制备骨髓间充质干细胞,剩余32只随机分为四组：ARDS组、HFOV组、MSCs移植组和HFOV＋ MSCs移植组（每组各8只）.全骨髓培养法体外培养兔MSCs,传至第3代备用.通过向气管内滴注内毒素建立ARDS模型.分别在干预后2、6及24 h时间点,取动脉血行血气分析.24 h后处死动物,取左肺上叶称质量后,计算湿质量/干质量比值（W/D）；右肺用10 mL生理盐水灌洗,收集灌洗液,检测中性粒细胞数目及蛋白含量；左肺下叶取标本,行病理学检查.结果 HFOV＋ MSCs组PaO2在三个时间点均明显高于ARDS组（P＜0.05）,在24h时间点分别与MSCs组及HFOV组比较差异也均有统计学意义（P＜0.05）；HFOV＋ MSCs组PaCO2在24 h时间点明显低于其余三组（P＜0.05）.与其余三组分别比较,HFOV＋ MSCs组24 h时间点W/D、支气管肺泡灌洗液中性粒细胞数目及蛋白含量均明显降低（P＜0.05）.肺组织病理学提示,HFOV组及MSCs组的损伤程度明显减轻,HFOV＋ MSCs组损伤最轻.结论 HFOV联合MSCs能明显改善内毒素诱发ARDS模型兔的PaO2和PaCO2,明显减轻炎症反应及肺损伤,优于单一方法,具有协同作用.Objective To investigate the prevention of endotoxin - induced acute respiratory distress syndrome in rabbit by high frequency oscillatory ventilation combined with bone marrow mesenchymal stem cells （ MSCs ） transplantation. Methods A total of 34 rabbits were used in this study. Two rabbits were utilized to culture BMSCs. 32 rabbits were randomly assigned to four groups： ARDS group, high frequency oscillatory ventilation （HFOV）group, BMSCs transplantation group and HFOV combined with MSCs transplantation group （n = 8 for each group）. Rabbit BMSCs were isolated and cultured by the whole bone marrow culture method. At the third passage, BMSCs were harvested for transplantation. Endotoxin was infused into the trachea to establish models of ARDS. Femoral arterial blood samples were obtained 2 h, 6 h and 24 h after intervention for blood gas analysis. 24 h after intervention, the upper lobe of left lung was weighed for calculating wet - to - dry weight ratio （W/D）. The right lung was lavaged with 10 mL of saline in order to detect the number of neutrophils and protein content in the lavage fluid. The lower lobe of left lung was excised for histological obseIvatiou. Results PaO2 in the HFOV ＋ MSCs group at three time points were higher than those in ARDS groups, respectively （P 〈 0.05）. PaO2 in HFOV ＋ MSCs group at 24 h was also compared to MSCs group and HFOV group respectively, and the differences were statistically significant （ P 〈 0.05 ） ; PaCO2 in the HFOV ＋ MSCs group at 24 h was significantly lower than those in the other three groups （ P 〈 0.05 ）. The HFOV ＋ MSCs group at 24 h was significantly reduced in W/D, bronchoalveolar lavage fluid neutrophil number and protein content compared with the other three groups. The lung histological injury was lowest in HFOV ＋ MSCs group and significantly reduced in HFOV and MSCs group. Conclusion HFOV combined with MSCs transplantation can significantly and synergistically improve arterial oxygenation and arterial partial press

关 键 词：高频振荡通气(HFOV) 骨髓间充质干细胞(MSCs) 急性呼吸窘迫综合征(ARDS) 

分 类 号：R542.22[医药卫生—心血管疾病]