冲击波复合四氧化二氮染毒致大鼠肺损伤的特点及可能机制研究  

Characteristics of pulmonary injury induced by blast wave combined with nitrogen tetroxide in rabbits and its molecular mechanism

作　　者：岳茂兴[1] 彭瑞云[2] 杨志焕[3] 王德文[2] 王正国[3] 杨鹤鸣[1] 夏亚东[3] 高亚兵[2] 崔雪梅[2] 李建忠[1] 李晓炎[3] 

机构地区：[1]解放军第306医院,北京 100101 [2]解放军军事医学科学院,重庆 400042 [3]第三军医大学野战外科研究所,北京 100850

出　　处：《创伤外科杂志》2003年第1期38-41,共4页Journal of Traumatic Surgery

基　　金：解放军总装备部卫生局重点指令性攻关课题; (No.200010306 )

摘　　要：目的　探讨冲击波复合四氧化二氮 (N2 O4)染毒致大鼠冲毒复合伤肺组织损伤特点及其分子机制。方法　采用Wistar雄性大鼠复制冲击伤、N2 O4染毒及复合效应动物模型 ,于伤后 3,6 ,12 ,2 4 ,4 8及 72小时活杀动物 ,进行主要器官病理形态学检查 ,血气分析并采用H&E及SP免疫组化技术观察大鼠肺组织损伤病变特点及c fos蛋白表达的变化和肥大细胞的数量。结果　三组动物动脉血氧分压 (PaO2 )均在伤后 2～ 6小时内显著下降 ,以冲击伤 +N2 O4组动物下降最为显著 ,重者死于呼衰。三组动物的主要病理形态学均有改变 ,以冲击伤 +N2 O4组动物最甚 ;免疫组化显示 ,冲击伤组和N2 O4组动物c fos蛋白表达均明显增加 ,而冲击伤 +N2 O4组动物c fos表达持续呈强阳性 ,其阳性部位以支气管上皮、血管内皮和单核细胞为主。另外 ,大鼠肺组织出现大量的肥大细胞。结论　单纯冲击伤和单纯N2 O4中毒组动物早期血气均有显著变化 ;N2 O4冲毒复合伤对大鼠血气的影响最为显著。另外 ,三组动物的主要病理形态学均有改变 ,以冲击伤 +N2 O4组动物最甚 ;实验结果表明 ,c fos蛋白表达及出现大量的肥大细胞参与了冲毒复合伤对大鼠肺损伤的加重过程。提示对冲毒复合伤进行早期救治 (在染毒致伤后 2～ 6小时内 )的重要性。Objectve To investigate the blood gases changes,pathomorphologic changes and c fos expression of the rabbits induced by blast wave combined with Nitrogen Tetroxide.?Methods The blast wave,intoxication of Nitrogen Tetroxide and their combining models were reproduced and the rabbits were killed at 3,6,12,48 and 72 h respectively after injury. The changes of pathomorphology,blood gases and the expression of c fos gene were then examined.?Results The PaO 2 of rabbits of the three models,especially that of the combining model,were decreased significantly 2 6 h after injury,and several rabbits died of respiratory failure. Each group had pathomorphologic changes of the main apparatus with that of the combining model group were the worst. Immunohistochemistry examination indicated that c fos gene expression was significantly enhanced in rabbits of the three groups and showed persistent positive stain in rabbits of the combining model group. C fos gene mainly expressed in the monocytes and the epithelia of bronchus and vascula.?Conclusion The blast injury and intoxication of Nitrogen Tetroxide could significantly affect the blood gas of the rabbits.?The pathomorphologic changes showed the most severe in rabbits of the blast intoxication combining model.?All these indicated that the c fos expression plays a key point in the blast intoxication combining injury of lung in rabbits.

关 键 词：冲击波 四氧化二氮 冲毒复合伤 血气变化 病理形态学 肺损伤 C-FOS蛋白 肥大细胞 

分 类 号：R655.3[医药卫生—外科学] R642[医药卫生—临床医学]