乌司他丁对中暑急性肺损伤HIF-1α、MIF表达水平的影响  

Effect of ulinastatin on expressions of hypoxia-inducible factor-1αand macrophage migration inhibitory factor in patients with acute lung injury induced by heat stroke

作　　者：李冰[1] 杨元立 王美霞[1] 曹枫[1] 刘先福[1] 张红璇[2] Li Bing;Yang Yuanli;Wang Meixia;Cao Feng;Liu Xianfu;Zhang Hongxuan(Intensive Care Unit,Longgang Central Hospital of Shenzhen City,Shenzhen 518116,China;Eastern Section,Guangdong General Hospital,Guangdong Institute of Geriatrics,Guangzhou 510080,China)

机构地区：[1]深圳市龙岗中心医院重症医学科,518116 [2]广东省人民医院东病区,广东省老年医学研究所,广州510080

出　　处：《国际呼吸杂志》2019年第21期1632-1637,共6页International Journal of Respiration

摘　　要：目的探讨缺氧诱导因子1α(HIF-1α)、巨噬细胞移动抑制因子(MIF)在中暑急性肺损伤中的表达水平及乌司他丁对HIF-1α、M IF表达水平的影响.方法选取2016年5月至2018年3月于深圳市龙岗中心医院确诊并住院治疗的中暑患者为研究对象(n=90),按照随机数字表法分为常规治疗组(n=45)和乌司他丁治疗组(常规治疗基础上加用乌司他丁,n=45);选取同期于深圳市龙岗中心医院体检的正常健康志愿者为对照组(对照组不接受任何治疗,n=90).中暑患者按照《职业性中暑诊断标准》进一步分为:先兆中暑组(n=30)、轻症中暑组(n=30)和重症中暑组(n=30).利用逆转录-聚合酶链反应、酶联免疫吸附试验和蛋白质印迹检测中暑急性肺损伤人群不同严重程度(先兆中暑组、轻症中暑组、重症中暑组)和不同治疗组(常规治疗组、乌司他丁组)外周血和肺泡灌洗液中HIF-1α、MIF的表达水平,分析其与中暑临床严重程度的相关性.结果病例组HIF-1α、MIF的表达水平明显高于对照组(P值均<0.05).随着病情严重程度的加重,H IF-1α、M IF的表达水平增高,轻症中暑组HIF-1α、MIF的表达水平高于先兆中暑组,重症中暑组HIF-1α、MIF的表达水平明显高于先兆中暑组和轻症中暑组,两两比较差异均有统计学意义(P值均<0.05);经不同方式治疗后患者HIF-1α、MIF的表达水平较治疗前均有明显下降(P值均<0.05);2种不同治疗方式对HIF-1α、MIF的表达水平影响的比较可发现,乌司他丁组HIF-1α、MIF的表达水平明显低于常规治疗组(P值均<0.05).中暑患者HIF-1α与MIF表达水平、HIF-1α水平与中暑临床严重程度、M IF水平与中暑临床严重程度均呈正相关(r值分别为0.45、0.78、0.63,P值均<0.05).结论在中暑急性肺损伤中,H IF-1α、M IF的表达显著增加,表达水平与中暑严重程度具有相关性;乌司他丁可减少HIF-1α、MIF的表达而发挥肺保护作用,减轻中暑急性肺损伤�Objective To investigate the expressions of hypoxia-inducible factor-1α(HIF-1α)and macrophage migration inhibitory factor(MIF)in patients with acute lung injury induced by heat stroke,and the effect of ulinastatin on the expressions of HIF-1αand MIF.Methods Ninety heat stroke patients in Longgang Central Hospital of Shenzhen City from May 2015 to March 2018 were enrolled,they were randomly divided into conventional group(n=45)and ulinastatin group(n=45).Another ninety healthy adults were selected as controls.According to the clinical features,the ninety heat stroke patients were divided into premonitory heat stroke group(n=30),mild heat stroke group(n=30),and severe heat stroke group(n=30).The levels of HIF-1αand MIF in peripheral blood and bronchoalveolar lavage fluid were measured with reverse transcription-polymerase chain reaction,enzyme linked immunosorbent assay and Western blot,the relationship of them with severity of heat stroke was analysed.Results The expressions of HIF-1αand MIF in the heat stroke group was obviously higher than those in the control group(all P<0.05).The levels of mRNA and protein of HIF-1αand MIF in the mild heat stroke group were obviously higher than those in the premonitory heat stroke group(all P<0.05),and the levels of mRNA and protein of HIF-1αand MIF in the severe heat stroke group were obviously higher than those in the mild heat stroke group and premonitory heat stroke group(all P<0.05).The expressions of HIF-1αand MIF were lower in the ulinastatin group than those in the conventional group(all P<0.05).There were positive correlations between HIF-1αand MIF level,HIF-1αlevel and clinical stages of heat stroke,MIF level and clinical stages of heat stroke,respectively(all P<0.05).Conclusions In the acute lung injury induced by heat stroke,the expressions of HIF-1αand MIF are significantly increased,which is closely related to the severity of heat stroke.Ulinastatin can play a protective role by reducing expressions of HIF-1αand MIF,attenuate acute lung injury induce

关 键 词：缺氧诱导因子1 Α亚基 巨噬细胞移动抑制因子 急性肺损伤 中暑 乌司他丁 

分 类 号：R73[医药卫生—肿瘤]