家兔神经源性肺水肿动物模型血管活性物质水平和肾上腺素β受体改变的研究  

Changes of vasoactive substances and adrenergic beta receptors in rabbit models of neurogenic pulmonary edema

作　　者：孙立波 幸春林 张晓磊 陆国平 Sun Libo;Xing Chunlin;Zhang Xiaolei;Lu Guoping(Department of Critical Care Medicine,Children's Hospital of Fudan University,Shanghai 201102,China)

机构地区：[1]复旦大学附属儿科医院重症医学科,上海201102

出　　处：《中国小儿急救医学》2019年第2期123-128,共6页Chinese Pediatric Emergency Medicine

基　　金：上海市科学技术委员会科研计划项目课题(124119a2700).

摘　　要：目的建立神经源性肺水肿(neurogenic pulmonary edema,NPE)动物模型,研究儿茶酚胺、β受体在NPE发生中的作用。方法24只家兔按照随机数字表法分为对照组、生理盐水组、实验组,每组8只。对照组只进行小脑延髓池穿刺,不注入药物;生理盐水组小脑延髓池穿刺后抽出脑脊液注入等量生理盐水;实验组通过小脑延髓池注入纤维蛋白原和凝血酶。穿刺前气管切开插管,分离股动脉和颈内静脉连接PiCCO仪器,分别在穿刺前及穿刺后1min、10min、30min检测血压、心率、呼吸。分别在穿刺前及穿刺后1min、10min留取血清标本测定肾上腺素、去甲肾上腺素、乙酰胆碱、内皮素-1、肌钙蛋白I、脑钠肽、神经肽Y水平。造模成功后3h处死家兔,行肺组织病理学检查。留取心肌标本检测肾上腺素β受体mRNA表达水平。结果(1)实验组小脑延髓池穿刺后1min和穿刺后10min心率、呼吸和平均动脉压均显著高于对照组和生理盐水组。(2)实验组家兔病理学检查发现肺组织肿胀,外观暗红,出现大片淤血。镜下显示肺组织水肿、出血,肺泡腔内有较多炎性细胞浸润,符合NPE特征。(3)小脑延髓池穿刺前各组血清肾上腺素、去甲肾上腺素浓度差异无统计学意义(P>0.05)。实验组穿刺后1min肾上腺素、去甲肾上腺素浓度分别为(200.0±251.7)μg/L、(448.9±356.7)μg/L,显著高于对照组[(15.4±3.4)μg/L、(15.9±9.6)μg/L]和生理盐水组[(17.1±3.8)μg/L、(29.6±18.4)μg/L](P<0.05)。实验组穿刺后10min肾上腺素、去甲肾上腺素浓度分别为(397.0±797.7)μg/L、(221.4±173.7)μg/L,显著高于对照组[(23.3±6.4)μg/L、(18.8±3.9)μg/L]和生理盐水组[(16.7±9.1)μg/L、(20.3±6.5)μg/L](P<0.05)。(4)三组血清神经肽Y、乙酰胆碱和内皮素-1水平在实验过程中差异无统计学意义。(5)实验组心肌肾上腺素β1受体mRNA表达平均为0.37±0.12,显著低于对照组(0.54±0.13)和生理盐水组(0.56±0.14)(P<0Objective To establish an animal model of neurogenic pulmonary edema(NPE),and to study the role of catecholamine and beta receptors in the occurrence of NPE.Methods The NPE model was established by injecting fibrinogen and thrombin into the cerebellum medullary pool of the rabbits.Twenty-four rabbits were divided into the control group,the saline group and the experimental group by random number table.In the control group,only cerebellar medullary cistern puncture was carried out,and no drug was injected.Cerebrospinal fluid was drew out and the same amount of saline was injected into the cerebellum medullary pool in the saline group.Fibrinogen and thrombin were injected into the cerebellum medullary pool in the experimental group.The animals were intubated by tracheotomy,the femoral artery and the internal jugular vein were dissected and connected with the PiCCO instrument to detect the blood pressure,heart rate,and respiratory rate before puncture and at 1 min,10 min,30 min after puncture.Serum samples were collected for the determination of epinephrine,norepinephrine,acetylcholine,endothelin-1,cardiac troponin I,brain natriuretic peptide and neuropeptide Y levels before puncture and at 1 min,10 min after puncture.The rabbits were sacrificed at 3 hours after successful modeling,the pathological examination of lung was performed.Myocardial samples were taken to detect adrenergic beta receptors mRNA.Results(1)The heart rate,respiratory rate and mean arterial pressure at 1 min and 10 min after puncture in experimental group were significantly higher than those in control group and saline group.(2)The pathological examination of the rabbits'lungs in experimental group found that the lung tissue was swollen and dark red in appearance with large areas of congestion.Under the microscope,the lung tissue was edema,bleeding,and inflammatory cells were infiltrated in the alveolar cavity,which was consistent with characteristics of NPE.(3)There was no difference in epinephrine and norepinephrine concentration in all groups

关 键 词：神经源性肺水肿 儿茶酚胺 Β受体 家兔 

分 类 号：R-332[医药卫生] R563