乌司他丁对机械通气相关性肺损伤的保护作用及其机制研究  

Protective Effect and Mechanism of Ulinastatin for Ventilation-induced Lung Injury in Rats

作　　者：肖正华[1] 古君[1] 秦超毅[1] 胡佳[1] 方智[1] 蒙炜[1] 

机构地区：[1]四川大学华西医院心脏大血管外科,成都610041

出　　处：《中国胸心血管外科临床杂志》2016年第10期1001-1005,共5页Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

基　　金：国家自然科学基金(81500213;81370413)~~

摘　　要：目的探讨乌司他丁对机械通气相关性肺损伤(VILI)的保护作用及相关机制。方法 24只SD大鼠,随机分为对照组、VILI组和乌司他丁治疗组(VILI+乌司他丁组)。检测肺泡灌洗液中高迁移率族蛋白1(high mobility group box-1,HMGB-1)、肿瘤坏死因子(tumor necrosis factor,TNF)-α、白细胞介素(IL)-6,肺组织中Toll样受体4(toll like receptor-4,TLR4)表达情况,肺湿干重比及肺病理损伤情况。结果 VILI组肺泡灌洗液中HMGB-1、TNF-α、IL-6水平、肺组织中TLR4表达、肺干湿重比和肺病理损伤评分均高于对照组,且差异有统计学意义(P<0.05);VILI+乌司他丁组肺泡灌洗液中HMGB-1、TNF-α、IL-6水平、肺组织中TLR4表达、肺干湿重比和肺病理损伤评分均低于VILI组,且差异有统计学意义(P<0.05)。结论乌司他丁可能通过减少HMGB-1分泌,继而减少其通过TLR4刺激肺炎症反应产生水平,达到保护VILI所致肺损伤。Objective To investigate the effect and mechanism of ulinastatin to ventilator induced lung injury （VILI）. Methods Total 24 SD rats were randomly divided into a control group, a VILI group, and a VILI＋ ulinastatin group. High mobility group box-1 （HMGB-1）, tumor necrosis factor （TNF）-a and interleukin （IL）-6 in bronchoalveolar lavage fluid, toll like receptor-4, dry/wet ratio and pathological scores of lung tissue were detected in the three groups. Results HMGB-1, TNF-a, and IL-6 in bronchoalveolar lavage fluid, toll like receptor-4, dry/wet ratio and pathological scores of lung tissue were significantly higher in the VILI group than those in the control group with statistical differences （P〈0.05）. While HMGB-1, TNF-a, and IL-6 in bronchoalveolar lavage fluid, toll like receptor-4, dry/wet ratio and pathological scores of lung tissue were reduced in the VILI＋ ulinastatin group compared with those in the VILI group. Conclusion Ulinastatin may protect ventilator induced lung injury by reducing inflammation level in lung through HMGB- 1 -TLR4 pathway.

关 键 词：机械通气相关性肺损伤 高迁移率族蛋白1 TOLL样受体4 肿瘤坏死因子-α 白细胞介素-6 

分 类 号：R614[医药卫生—麻醉学]