甲泼尼龙通过减少巨噬细胞M1极化对急性肺损伤产生防治作用  

The preventive and therapeutic effect of methylprednisolone for acute lung injury by reducing the M1 polarization of macrophages

作　　者：谢建刚[1] 冯筑生 尹文[1] 黄杨[1] 王玉同[1] 赵威[1] 周宁[2] 李俊杰[1] XIE Jian＇gang;FENG Zhusheng;YIN Wen;HUANG Yang;WANG Yutong;ZHAO Wei;ZHOU Ning;LI Junjie(Department of Emergency, Xijing Hospital, the Forth Military Medical University, Xi＇an, 710032, China;Gamma Knife Center, Bethune International Peace Hospital of PLA)

机构地区：[1]第四军医大学西京医院急诊科,西安710032 [2]解放军白求恩国际和平医院伽马刀中心

出　　处：《临床急诊杂志》2018年第3期180-184,共5页Journal of Clinical Emergency

基　　金：国家自然科学青年基金(No:81500492)

摘　　要：目的:观察甲泼尼龙对急性肺损伤的防治作用。方法:取大耳白兔32只,随机分配为对照组(n=8)、处理组(n=8)、甲泼尼龙治疗组(n=8)。对照组经颈静脉注入生理盐水(1ml/kg);处理组经颈静脉注入脂多糖(LPS,1ml/kg);治疗组先经腹腔注入甲泼尼龙(5mg/kg),后2min经颈静脉在注入脂多糖(LPS,1ml/kg)。测定各组肺动脉压,动脉血氧分压,外周血白细胞计数,分离各组肺泡巨噬细胞并流式细胞术检测巨噬细胞极化,QPCR检测肺组织中白细胞介素-1β、白细胞介素-6、肿瘤坏死因子-α的mRNA表达。结果 :治疗组氧分压较处理组明显改善(P<0.01),外周血白细胞高于处理组(P<0.01)。处理组巨噬细胞M1极化,白细胞介素-1、白细胞介素-6和肿瘤坏死因子-α的mRNA表达均较对照组明显升高,治疗组较处理组表达下降。结论 :甲泼尼龙对可能通过抑制巨噬细胞向M1极化以减轻炎症细胞浸润,对急性肺损伤产生防治作用。Objective：To observe the preventive and therapeutic effect of methylprednisolone for acute lung injury.Method：Thirty two rabbits were randomly divided into control group（n=8）,experimental group（n=8）and methylprednisolone group（n=8）（LPS,1 ml/kg）.In control group,normal saline（1 ml/kg）was injected through the jugular vein.In experimental group,lipopolysaccharide（LPS,1 ml/kg）was injected through the jugular vein.In methylprednisolone group,lipopolysaccharide（LPS,1 ml/kg）was injected through the jugular vein and methylprednisolone（5 mg/kg）was injected intraperitoneally two minutes ago.The pulmonary arterial pressure,arterial oxygen pressure and peripheral white blood cell count were measured.The alveolar macrophages were isolated and the macrophage polarization was detected by flow cytometry.The expression of interleukin-1β,interleukin-1β-6,the expression of tumor necrosis factor-αmRNA was detected by QPCR.Result：The oxygen partial pressure was significantly improved（P0.01）,and the peripheral white blood cell was higher in methylprednisolone group than experimental group（P0.01）.The macrophage M1 polarization,interleukin-1,interleukin-6 and tumor necrosis factor-αmRNA expression were significantly higher in experimental group than the control group,and was significantly reduced in methylprednisolone group than experimental group.Conclusion：Methylprednisolone can relieve the infiltration of inflammatory cells by inhibiting the polarization of macrophages to M1 and is able to prevent and treat acute lung injury.

关 键 词：急性肺损伤 甲泼尼龙 巨噬细胞 

分 类 号：R563[医药卫生—呼吸系统]