沙漠干热环境创伤失血性休克继发性肺损伤及相关炎症因子变化  

Changes of Inflammatory Factors and the Secondary Lung Injury of Traumatic Hemorrhagic Shock in Dry Heat Environment of Desert

作　　者：吴彬 沈才福 丁玉庆[3] 曹东 冯开相 刘江伟[1] 康燕[4] WU Bin;SHEN Cai-fu;DING Yu-qing;CAO Dong;FENG Kai-xiang;LIU Jiang-wei;KANG Yan(KeyLaboratory of Special Environmental Medicine,General Hospital of Xinjiang Military Command,Urumqi,Xinjiang,830000,China;Lintong rehabilitation and recuperation center of the Chinese people's Liberation Army,Xi'an,Shaanxi,710000,China;369223 people's Liberation Army of China,Aksu,Xinjiang,842300 China;469240 Army Hospital of the people's Liberation Army of China,Urumqi,Xinjiang,830000,China)

机构地区：[1]新疆军区总医院新疆特殊环境医学重点实验室,新疆乌鲁木齐830000 [2]中国人民解放军联勤保障部队临潼康复疗养中心,陕西西安710000 [3]中国人民解放军69223部队,新疆阿克苏842300 [4]中国人民解放军69240部队医院,新疆乌鲁木齐830000

出　　处：《现代生物医学进展》2020年第17期3227-3232,共6页Progress in Modern Biomedicine

基　　金：解放军总后勤部面上基金项目(CLZ13J003)。

摘　　要：目的:探讨沙漠干热环境下创伤失血性休克(THS)猪不同时间点继发性肺损伤特点及炎症因子的变化。方法:健康长白仔猪60只,随机分为3组,分别为:干热创伤失血性休克组(DHS组),干热创伤失血性休克假手术组(DHC组),常温创伤失血休克组(NTS组),每组20只。实验前将DHS组和DHC组在干热环境(温度40.5±0.5℃,湿度10%±2%),NTS组在常温环境(温度25.0±0.5℃,湿度35%±5%)分别在相应的环境下暴露3 h后建立模型,再将DHS组、DHC组和NTS组分别随机分成4个亚组(n=5):分别于模型建立成功后0 min,50 min,100 min,150 min安乐处死并取肺组织观察病理学变化,检测肺组织匀浆液内TNF-α、IL-1β含量变化及肺组织内i NOS、COX-2 m RNA表达量的变化。结果:高倍镜下病理切片可见DHS组各时间点肺均有不同程度的损伤,随时间延长呈逐渐加重趋势,病理学评分也不断升高;DHC组与NHC组在各时间点肺组织均未出现明显的病理学变化。DHS组肺组织匀浆液中细胞炎症因子TNF-α、IL-1β分别在时间点T0、T1开始升高,峰值分别出现在T2、T3时间点;DHS组肺组织内i NOS、COX-2 m RNA在T0时间点即明显表达,在相同时间点分别和NTS组、DHC组比较,i NOS、COX-2 m RNA相对表达量差异有显著性(P<0.05)。结论:沙漠干热环境下,创伤失血性休克猪继发性肺损伤出现时间早、损伤重且肺组织匀浆内炎性因子TNF-α、IL-1β发生级联效应,肺组织内i NOS、COX-2在肺损伤过程中可能起关键作用。Objective: To explore the characteristics of secondary lung injury and the changes of inflammatory factors in pigs with traumatic hemorrhagic shock(THS) at different time points under the dry heat environment of desert. Methods: 60 healthy Landrace piglets were randomly divided into three groups: Dry heat trauma hemorrhagic shock group(DHS group), dry heat trauma hemorrhagic shock sham operation group(DHC group), normal temperature trauma hemorrhagic shock group(NTS group), 20 in each group. Before the experiment, the DHS group and the DHC group were exposed to dry heat(temperature 40.5±0.5 ℃, humidity 10 %±2 %), and the NTS group was exposed to normal temperature(temperature 25.0±0.5 ℃, humidity 35 %±5 %) for 3 hours respectively. Then the DHS group, the DHC group and the NTS group were randomly divided into four subgroups(n=5): the lung tissues were euthanized and taken at 0 minutes, 50 minutes, 100 minutes and 150 minutes after the model was established successfully The content of TNF-α and IL-1β in lung homogenate and the expression of i NOS and COX-2 m RNA were observed. Results: Under high power microscope, the lung of DHS group was damaged in different degrees at different time points, and gradually increased with time, and the pathological score was also rising;there was no significant pathological blood change in lung tissue of DHC group and NHC group at different time points. The levels of TNF-α and IL-1β in lung homogenate of DHS group increased at T0 and T1 respectively, and the peak values appeared at T2 and T3 respectively;i NOS and COX-2 mRNA were significantly expressed at T0 in lung tissue of DHS group, and there was a significant difference in the relative expression of i NOS and COX-2 mRNA compared with NTS group and DHC group at the same time point(P<0.05).Conclusion: In the dry heat environment of desert, the secondary lung injury of pigs with traumatic hemorrhagic shock occurs early and seriously, and the inflammatory factors TNF-α and IL-1β in lung homogenate have cascade effe

关 键 词：创伤失血性休克 干热环境 急性肺损伤 炎症因子 猪 

分 类 号：R-33[医药卫生] R605.971