新生VAP小鼠和肽素IL-32 IL-17水平变化与不同程度肺炎的相关性分析  

Correlation Analysis of Neonatal VAP Mice and Copeptin IL-32 IL-17 Levels and Different Degrees of Pneumonia

作　　者：方平[1] 王娅 吴迪 赵婧[2] FANG Ping;WANG Ya;WU Di(North Sichuan Medical College,Sichuan Nanchong 637100,China)

机构地区：[1]川北医学院,四川南充637100 [2]川北医学院附属医院儿科,四川南充637000

出　　处：《河北医学》2021年第9期1409-1413,共5页Hebei Medicine

基　　金：国家自然科学基金青年项目,(编号:81300528);四川省科技厅面上项目,(编号:2017JY0115);南充市科学技术和知识产权局项目,(编号:14A0058);川北医学院附属医院科技发展计划项目,(编号:2019ZD010)。

摘　　要：目的:探讨呼吸机相关性肺炎(VAP)的发病症状与影响因素,为临床诊断与治疗提供基础。方法:将54只BALB/c雄性小鼠随机分为空白组、VAP轻症组(1×10^(6)cfu/L菌液)、VAP重症组(6×10^(6)cfu/L菌液),每组18只。除空白组外,其余各组小鼠进行机械通气24h与气管滴注铜绿假单胞菌构建VAP模型。模型构建后1d、3d、7d分别测定用力肺活量(FVC)、第1秒用力呼气量(FEV1),计算FEV1/FVC%值;ELISA法测定血清中Copeptin、IL-32、IL-17的含量;HE染色观察7d后肺脏中病理学改变;免疫组化法测定7d后肺组织NF-κB、TLR2与TLR4的表达水平;将肺功能与Copeptin、IL-32、IL-17的测定结果进行相关性分析,对Copeptin、IL-32、IL-17的结果进行ROC分析,评价VAP的影响因素。结果:VAP发生7d内,与空白组相比,轻症组与重症组动物的FVC、FEV1降低,血清中Copeptin、IL-32、IL-17升高(P<0.05);肺脏中炎性细胞、中性粒细胞数量,以及TRL2、TRL4、NF-κB蛋白的表达随VAP症状的加重而增多;相关性分析与ROC分析的结果显示:肺功能指标与Copeptin、IL-32、IL-17水平呈密切关联性,趋势呈负相关。结论:呼吸机相关性肺炎的发病程度与Copeptin、IL-32、IL-17具有密切相关性,其机制可能与激活NF-κB通路介导炎症反应相关,从而降低肺功能。Objective:To explore the symptoms and influencing factors of ventilator-associated pneumonia(VAP)to provide a basis for clinical diagnosis and treatment.Methods:54 Balb/c mice were randomly divided into a control group,mild group(1×10^(6 )cfu/L),severe group(6×10^(6) cfu/L)(n=18).Except for the control group,mice were mechanically ventilated for 24 hours and tracheal instillation of Pseudomonas aeruginosa to construct a VAP model.Forced vital capacity(FVC)and forced expiratory volume in the first second(FEV1)were measured at 1,3,and 7 days after the model was constructed,respectively,and the value of FEV1/FVC%was calculated.The contents of Copeptin,IL-32 and IL-17 in serum were determined by ELISA.The staining was used to observe the histopathological changes of lung after 7 days.The protein expression levels of NF-κB,TLR2 and TLR4 in lung tissues were determined by immunohistochemical after 7 days.The lung function indexes were correlated with the levels of Copeptin,IL-32 and IL-17.The results of Copeptin,IL-32,IL-17 and the incidence of VAP were analyzed by ROC to evaluate the risk factors of VAP.Results:Within 7 days after the occurrence of VAP,compared with the control group,the FVC and FEV1 levels of the mild and severe groups were decreased,while the serum levels of Copeptin,IL-32 and IL-17 were increased(P<0.05);The number of inflammatory cells,neutrophils and the expression of TRL2,TRL4 and NF-κB protein in lung increased with the aggravation of VAP symptoms;Correlation analysis and ROC analysis showed that lung function indexes were closely correlated with the levels of Copeptin,IL-32,and IL-17,with a negative correlation trend.Conclusion:The incidence of ventilator-associated pneumonia is closely related to Copeptin,IL-32 and IL-17,and its mechanism may be related to the activation of NF-κB pathway to mediate inflammatory response,thereby reducing lung function.

关 键 词：呼吸机相关性肺炎 和肽素 IL-32 IL-17 

分 类 号：R563.1[医药卫生—呼吸系统]