地塞米松对高原肺水肿大鼠的影响研究  

Impact of Dexamethasone on Rats with High Altitude Pulmonary Edema

作　　者：胡小艳[1] 汤恩杰 

机构地区：[1]第三军医大学西南医院麻醉科,重庆市400038 [2]空军邛崃场站医院,四川省邛崃市611530

出　　处：《实用心脑肺血管病杂志》2017年第4期56-62,共7页Practical Journal of Cardiac Cerebral Pneumal and Vascular Disease

基　　金：国家科技支撑计划项目(2009BAI85B03)

摘　　要：目的探讨地塞米松对高原肺水肿(HAPE)大鼠的影响。方法 2016年5—10月于第三军医大学高原医学教育部重点实验室和西南医院中心实验室进行实验。选取成年SD大鼠90只,采用随机数字表法分为A组、B组和C组,每组30只,剔除实验过程中死亡大鼠后A组纳入22只,B组纳入29只,C组纳入22只。3组大鼠均进行力竭运动,后将B组和C组大鼠低氧暴露48 h以建立HAPE模型,减压低氧暴露48 h后B组大鼠予以0.9%氯化钠溶液300μl腹腔注射、1次/d,C组大鼠予以地塞米松300μg腹腔注射、1次/d;连续用药3次后处死所有大鼠。观察3组大鼠肺脏形态、肺组织学形态、肺组织超微结构及肺组织Occludin蛋白的表达,比较3组大鼠肺组织含水量、肺泡灌洗液蛋白质含量、肺泡壁血管内皮细胞Occludin蛋白相对表达量、血液和肺泡漏出液炎性因子水平。结果 (1)肺脏形态:A组大鼠肺叶表面光滑,呈浅粉红色且无泡沫溢出;B组大鼠肺叶肿大,肺表面呈暗红色,肺组织硬度增加,表面有点状出血和脓肿形成,切面有较多泡沫溢出;C组大鼠肺表面光滑,呈浅粉红色,切面少有泡沫溢出,表面无出血和脓肿形成。(2)肺组织学形态:A组大鼠肺泡结构正常,肺泡腔内无红细胞和粉红色蛋白样物质;B组大鼠肺组织结构较致密,肺质地实变,肺血管高度扩张充血,肺泡壁增厚,肺泡间隔增宽,肺泡腔内可见大量红细胞;C组大鼠仅部分肺泡壁增厚,部分肺泡间隔增宽,肺泡腔内未见红细胞和粉红色蛋白样物质。(3)肺组织超微结构:A组大鼠肺泡壁血管膜双层结构清晰,结构正常,无融合和断裂;B组大鼠一侧肺泡壁血管膜双层结构的上皮层疏松、完全断裂或融合,结构模糊不清,内皮层疏松呈串珠状;C组大鼠肺泡壁血管膜双层结构清晰,部分区域血管膜双层结构似有融合。(4)肺组织含水量及肺泡灌洗液蛋白质含量:A、C组大鼠肺组织含水量、肺泡灌洗液Objective To investigate the impact of dexamethasone on rats with high altitude pulmonary edema （HAPE）. Methods From May to October in 2016, the experiment was carried out in the Key Laboratory Ministry of Education for High Altitude Medicine in the Third Military Medical University and Central Laboratory of Southwest Hospital. A total of 90 adult SD rats were randomly divided into A group, B group and C group according to random number table, each of 30 cases; excluded the dead rats during the experiment, eventually 22 rats involved in A group, 29 rats involved in B group, and rats involved in C group. Rats of the three groups take the exhaustion exercise, then rats of B group and C group received hypoxic exposure to prepare HAPE model; after 48 hours of decompressive hypoxic exposure, rats of B group received intraperitoneal injection of O. 9% sodium chloride injection （300 μl）, 1 time per day, rats of C group received intraperitoneal injection of dexamethasone （300 μg） 1 time per day; both B group and C group continuously injected for 3 times, then rats of the three groups were killed. Lung morphology, lung histological performance, lung ultrastructure and expression of Occludin protein in lung tissue of the three groups were observed, lung water content and bronchoalveolar lavage fluid protein content, relative expression quantity of Occludin protein of vascular endothelial cells of alveolar wall, blood and alveolar transudation inflammatory cytokines levels were compared among the three groups. Results （ 1 ） Lung morphology： lung lobes of A group A were smooth, pale pink, without foam spill; lung lobes of B group were dropsical, with dark red lung surface, increased solidity of lung tissue, punetate bleeding and abscess, and relatively large foam spill; lung surface of C group was smooth, pale pink, with relatively less foam spill, without bleeding or abscess in lung surface. （2） Lung histological performance： alveolus structure of A group was normal, without red blood cells or pink

关 键 词：肺水肿 大鼠 地塞米松 炎性反应 水肿 

分 类 号：R541.63[医药卫生—心血管疾病]