重症肺炎大鼠血清肺和肠组织中表面活性蛋白-A的变化规律  

The change rule of surfactant protein-A in serum,lung and intestinal tissues of rats with severe pneumonia

作　　者：李冠胜 孙小平[1] 张瑾[1] 邓扬嘉[1] 吴倩[1] Li Guan-sheng;Sun Xiao-ping;Zhang Jin;Deng Yang-jia;Wu Qian(Department of Emergency&Critical Care Medicine,Chongqing Traditional Chinese Medicine Hospital(Daomenkou Department),Chongqing 400010,China)

机构地区：[1]重庆市中医院(道门口院部)重症医学科,重庆400011

出　　处：《中国急救医学》2022年第9期791-797,共7页Chinese Journal of Critical Care Medicine

基　　金：重庆市自然科学基金面上项目(cstc2020jcyj-msxmX1010)。

摘　　要：目的探讨表面活性蛋白-A(surfactant protein-A,SP-A)在重症肺炎大鼠模型血清、肺、结肠组织中的变化规律。方法将60只SD健康雄性大鼠随机分为对照组和重症肺炎组,分别在造模成功后即刻、12 h、24 h、36 h、48 h处死大鼠并留取血液、支气管肺泡灌洗液(bronchoalveolar lavage fluid,BALF)、肺组织、肠组织标本。通过酶联免疫吸附(ELISA)方法检测血液和BLAF中SP-A和肿瘤坏死因子-α(tumor necrosis factor-α,TNF-α);蛋白质印迹法(Western blot)、免疫荧光和HE染色检测肺、肠组织中SP-A和TNF-α的表达。结果与对照组比较,重症肺炎组各时间段BALF中的SP-A降低,而血清SP-A和TNF-α升高(P<0.05);与对照组比较,重症肺炎组各时间段肺组织SP-A表达降低,肠组织SP-A在建模后12 h短暂升高,在12 h后降低(P<0.05);而肺、肠组织中TNF-α的表达较对照组均升高(P<0.05);HE染色可见重症肺炎组肺、肠组织损伤呈逐渐加重趋势,肺组织损伤程度大于肠组织。结论SP-A不仅可评价血气屏障的完整性,也可判断肠黏膜损伤程度,通过检测血清中SP-A的变化可早期判断重症肺炎的病情进展。Objective To explore the change rule of surfactant protein-A(SP-A)in serum,lung and intestinal tissues in the rat models of severe pneumonia.Methods Sixty SD healthy male rats were randomly divided into control group and severe pneumonia model group.Blood,bronchoalveolar lavage fluid(BALF),lung and intestinal tissue samples were collected when the rats were sacrificed at once and 12 h,24 h,36 h and 48 h after modeling,respectively.SP-A and tumor necrosis factor-α(TNF-α)indexes in blood and BLAF were detected by ELISA.Western blot,immunofluorescence and HE staining were used to detect the expression of SP-A and TNF-αin lung and intestinal tissues.Results Compared with the control group,SP-A in BALF of severe pneumonia rat models decreased in each time period(P<0.05),while serum SP-A and TNF-αincreased(P<0.05);The expression of SP-A in the lung tissue of the severe pneumonia rat model group decreased at all times,but increased briefly at 12 h in the intestinal tissue,and decreased after 12 h(P<0.05);The expressions of TNF-αin lung and intestinal tissue were higher than those in the control group(P<0.05);By HE staining,the lung and intestinal tissues gradually showed bleeding and necrosis after modeling severe pneumonia,and cell swelling and inflammatory cell infiltration were noted.Conclusions SP-A can not only evaluate the integrity of blood gas barrier,but also determine the damage degree of intestinal mucosa.By detecting the changes of SP-A in serum,the progression and prognosis of severe pneumonia can be determined early.

关 键 词：重症肺炎 大鼠 表面活性蛋白-A(SP-A) 肿瘤坏死因子-α(TNF-α) 

分 类 号：R563.1[医药卫生—呼吸系统] R-332[医药卫生—内科学]