脾切除对内毒素诱发大鼠急性肺损伤的影响及机制  

The effect of splenectomy on endotoxin-induced acute lung injury and its potential mechanism in rats

作　　者：姚咏明 杨英祥 陆家齐 焦华波 于燕 盛志勇 

机构地区：[1]解放军第三O四医院创伤外科中心,北京100037

出　　处：《中华创伤杂志》2001年第9期540-543,共4页Chinese Journal of Trauma

基　　金：国家重点基础研究发展规划专项经费资助项目(G19990 5 42 0 3 ) ;国家自然科学基金资助项目 (3 9870 2 86) ;军队杰出中青年人才专项基金资助项目 (98J0 13 ) ;军队十五医药卫生科研基金资助项目 (0 1MA2 0 7)

摘　　要：目的　探讨脾切除对内毒素血症诱发急性肺损伤的影响及其增敏机制。　方法　将雄性Wistar大鼠 112只随机分为脾切除组 (5 6只 )和假手术对照组 (5 6只 ) ,前者采用大鼠脾切除合并低剂量内毒素 (0 .1mg/kg)攻击模型 ,分别于注射内毒素前 ,注射后 10min和 0 .5 ,1.5 ,12 ,2 4h观察两组肺组织内毒素含量、脂多糖结合蛋白 (LBP)和肿瘤坏死因子α(TNF -α)mRNA表达、髓过氧化物酶 (MPO)活性及形态学改变。　结果　内毒素注射后 10min肺组织内毒素水平迅速升高并达峰值 ,脾切除组的升高幅度更明显。同时 ,肺组织LBPmRNA表达明显增强 ,1.5h达峰值 ,脾切除组注射后 1.5 ,4hLBPmRNA表达较有脾组分别升高 31.7%和 2 8.7% (P <0 .0 5 )。相关分析显示 ,LBPmRNA分别与TNF -αmRNA及MPO活性呈显著正相关 (r值分别为 0 .6 988、0 .44 17,P <0 .0 1)。形态学检查证实 ,脾切除大鼠肺组织炎症反应和细胞损害明显加重。　结论　脾切除可上调内毒素血症时肺脏LBP基因表达 。Objective To investigate the effect of splenectomy on endotoxin-induced acute lung injury and its potential mechanism. Methods A total of 112 male Wistar rats were randomly divided into asplenic group (Group A)and splenic group (Group B). The rats in gr oup A were subjected to splenectomy followed by a low-dose endotoxin challenge (0.1 mg/kg). Before injection of endotoxin and 10 minutes, 0.5, 1.5 , 12 and 24 hours after injection, tissue samples from lungs were collected to determine end otoxin levels, mRNA expression of lipopolysaccharide-binding protein (LBP) and tumor necrosis factor-α (TNF-α), myeloperoxidase (MPO) activity and histolo gical changes. Results After endotoxin administration, pulmonary end otoxin levels significantly increased, peaking at 10 minutes, and were much high er in Group A than that in Group B ( P <0.05). Meanwhile, pulmonary LBP mRNA e xpression was up-regulated in both groups following endotoxin challenge with pe ak value at 1.5 hours. Compared to animals without splenectomy, LBP mRNA express ion in asplenic animals increased respectively by 31.7% and 28.7% at 1.5, 4 hour s ( P <0.05). There was significant correlation between pulmonary LBP mRNA exp ression and local TNF-α mRNA expression or MPO activity ( r =0.6988, P <0 .01; r =0.4417, P <0.01). In addition, histological examination revealed that acute lung damage was pronounced in animals with splenectomy compared to th e controls. Conclusions The data suggest that splenectomy can m arkedly enhance endotoxin-mediated pulmonary LBP mRNA expression, which may pla y a role in the pathogenesis of acute lung injury associated with overwhelming post-splenectomy infection.

关 键 词：脾切除术 内毒素血症 脂多糖结合蛋白 急性肺损伤 

分 类 号：R631.1[医药卫生—外科学]