HFOV 联合 MSCs 移植对急性肺损伤后肺纤维化的影响  

The influence of high frequency oscillatory ventilation combined with bone marrow mesenchymal stem cell transplantation on lung fibrosis of acute lung injury

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,江西南昌330006 [2]中山大学附属第一医院,广东广州510080

出　　处：《中国急救医学》2014年第10期938-941,I0004,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）对内毒素诱发急性肺损伤模型兔肺纤维化的影响。方法家兔34只，2只用于制备MSCs，剩余32只随机分为4组：肺损伤组、HFOV组、MSCs移植组和HFOV＋MSCs移植组，每组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急性肺损伤／急性呼吸窘迫综合征模型。分别在干预后2周时间点，采用酸解法测定肺组织羟脯氨酸含量；采用ELISA法检测各组血清和支气管肺泡灌洗液中转化生长因子-β（ TGF-β）及单核细胞趋化蛋白-1（ MCP-1）的表达；取右肺一叶标本，行病理学检查。结果 MSCs组中肺组织羟脯氨酸含量、血清及支气管肺泡灌洗液中TGF-β、MCP-1的表达水平，分别与肺损伤组比较差异有统计学意义（P＜0．05），而单一HFOV组与肺损伤组比较差异均无统计学意义（P＞0．05）；联合HFOV＋MSCs组中肺组织羟脯氨酸含量、血清及支气管肺泡灌洗液中 TGF -β、MCP -1的表达水平最低，分别与单一HFOV组和MSCs组比较差异均有统计学意义（P＜0．05）。肺组织病理学提示，MSCs组的纤维化程度减轻，HFOV＋MSCs组程度最轻。结论 HFOV联合MSCs可减少急性肺损伤兔肺组织羟脯氨酸含量，降低TGF-β、MCP-1的表达，减轻急性肺损伤后纤维化程度，优于单一方法，具有协同作用。Objective To investigate the influence of high frequency oscillatory ventilation combined with bone marrow mesenchymal stem cell transplantation on lung fibrosis in endotoxin -induced acute lung injury in rabbits .Methods A total of 34 rabbits were used in this study .Two rabbits were utilized to culture BMSCs and the other 32 rabbits were randomly assigned to four groups , acute lung injury group , high frequency oscillatory ventilation （ HFOV ） group, MSCs transplantation group and HFOV combined with MSCs transplantation group （ n=8 ） .Rabbit BMSCs were isolated and cultured by the whole bone marrow culture method .At the third passage , BMSCs were harvested for use . Endotoxin was infused into the trachea to establish models of acute lung injury /ARDS.Two weeks after intervention , content of lung hydroxyproline of each group were measured by acid solution;expression of transforming growth factor β（ TGF-β） and monocyte chemoattractant protein -1 （ MCP-1 ） of serum and bronchoalveolar lavage fluid of each group were measured by ELISA .The lobe of right lung was excised for histological observation .Results Lung hydroxyproline content , TGF -βand MCP -1＆amp;nbsp;expression in serum and bronchoalveolar lavage fluid of MSCs group were compared with acute lung injury group, the differences were statistically significant （ P 〈0.05 ）; the difference of the single HFOV group and lung injury group was not statistically significant （P 〉0.05）.Lung hydroxyproline content, TGF-βand MCP -1 expression in serum and bronchoalveolar lavage fluid of the HFOV ＋MSCs group were lowest;the differences were statistically significant （P 〈0.05） when compared with HFOV group and MSCs group respectively .Conclusion HFOV combined with BMSCs transplantation reduce lung hydroxyproline content , TGF -βand MCP -1 expression , and extenuate the degree of fibrosis of acute lung injury in rabbits .It has a synergistic effect that was better than a single method .

关 键 词：高频振荡通气(HFOV) 骨髓间充质干细胞(MSCs) 急性肺损伤(ALI) 细胞因子 转化生长因子-β( TGF-β) 单核细胞趋化蛋白-1( MCP-1) 

分 类 号：R563[医药卫生—呼吸系统]