机械通气诱导肺损伤大鼠肺组织白细胞介素-8及表面活性蛋白B表达的变化  

The pulmonary expression of IL-8 and surfactant protein B in neonatal rat after mechanic ventilation induced lung injury

作　　者：冯继峰[1] 庞登戈[1] 王晓夏[1] 

机构地区：[1]广西壮族自治区妇幼保健院麻醉科,南宁市530003

出　　处：《临床麻醉学杂志》2015年第3期282-285,共4页Journal of Clinical Anesthesiology

基　　金：广西医疗卫生重点科研课题资助项目(编号:重2011061)

摘　　要：目的研究新生大鼠呼吸机相关性肺损伤模型肺组织白细胞介素（IL）-8及表面活性蛋白B（SPB）蛋白表达的变化,探讨新生大鼠呼吸机相关性肺损伤的发病机制。方法新生SD大鼠30只,体重12-18g,采用随机数字表法均分为三组：对照组（A组）、正常潮气量机械通气组（B组）和大潮气量机械通气组（C组）。A组气管插管后保持自主呼吸;B组和C组气管插管后行机械通气,B组潮气量7ml/kg,C组潮气量25ml/kg行机械通气4h。机械通气结束,采用光学显微镜下观察肺组织病理学改变,测定肺组织湿干重比（W/D）;采用ELISA检测三组肺泡灌洗液IL-8、IL-10及SPB的浓度的变化;Western blot检测肺组织匀浆IL-8、IL-10和SPB的蛋白表达。结果光镜下见A、B组肺组织病理改变不明显,C组肺组织病理学改变累计面积达50%,肺泡结构紊乱,肺间隔增宽,肺间质水肿,肺泡腔融合并有大量炎性细胞聚集。C组W/D明显高于A、B组（P〈0.05）。C组IL-8表达明显高于,SPB浓度明显低于A、B组（P〈0.01）,三组肺泡灌洗液中IL-10的表达水平差异无统计学意义。C组IL-8的蛋白表达明显高于,SPB的蛋白表达明显低于A、B组（P〈0.01）。结论 IL-8介导的肺部过度炎症反应及SPB下调是新生大鼠肺损伤的重要机制。Objective To research the expression of IL-8and SPB in neonatal rat lung tissue in the model of ventilator-induced lung injury.Methods Thirsty neonatal rats（weighing 12-18g）were randomly assigned to three groups.Control group（group A,n=10）rats had spontaneous breath after tracheostomy.The normal tidal volume ventilation group（group B,n=10）：neonatal rats received mechanical ventilation for 4hwith VT7ml/kg after tracheostomy.The large tidal volume ventilation group（group C,n=10）：neonatal rats received mechanical ventilation with VT25ml/kg for 4h.After the ventilation,histological examination was performed by microscope to observe the lung pathological changes.And the W/D of lung tissue was detected as well.The concentrations of IL-8,IL-10 and SPB in bronchoalveolar lavage fluid were detected by enzyme-linked immunosorbent assay（ELISA）.While the protein level of IL-8,IL-10 and SPB in the lung tissue were detected by Western blot.Results There were no major histological differences between animals ventilated with low VT（group B）compared to spontaneously breathing animals（group A）,whereas the total area of pathology change in the lung tissue of group C was almost 50% with alveolar structure disordered and marked alveolar septal thickening,pulmonary edema,alveolar space fusion and numerous inflammatory cells infiltration.Compare with groups A and B,W/D was significant increased in the group C（P〈0.05）,and the concentration of IL-8in bronchoalveolar lavage fluid was significant increased in the group C（P〈0.01）,whereas the concentration of SPB in the group C was significantly decreased（P〈0.01）.There were no significant differences in bronchoalveolar lavage IL-10 levels among the three groups.Conclusion The down-regulation of SPB and excessive lung inflammation mediated by IL-8play an important role in mechanisms of ventilator induce lung injury in neonatal rats.

关 键 词：呼吸机相关性肺损伤 新生儿 白细胞介素-8 表面活性蛋白B 

分 类 号：R614[医药卫生—麻醉学]