ICAM-1和NF-κB在产生胸膜固定术中的作用  

The mechanisms of experimental pleurodesis in rats induced by silver nitrate or Talc

作　　者：林慧庆[1] 黄杰[1] 程邦昌[1] 毛志福[1] 赵华[1] 王志强[1] 

机构地区：[1]湖北省武汉大学人民医院胸心外科,430060

出　　处：《重庆医学》2004年第2期187-190,共4页Chongqing medicine

摘　　要：目的　探讨硝酸银和滑石粉浆在大鼠产生胸膜固定术中ICAM 1和NF κB的作用 ,研究胸膜固定术产生的机制。方法　健康成年雄性Sprague Dawley大鼠 6 0只 ,随机分为T组 (滑石粉组 )和A组 (硝酸银组 ) ,在造成大鼠气胸模型后 ,A组注入硝酸银 (0 .1 %硝酸银 1ml) ,B组注入 2 0 0mg/kg滑石粉 +1 .0ml0 .9%生理盐水。两组分别在注射药物后第 1、4、7天、2、4周时进行剖胸探查收集标本 ,观察大鼠胸膜粘连积分、组织病理学改变及检测肺组织或胸膜组织中NF κB及ICAM活性 ,大鼠 2 4h胸液量。结果　滑石粉浆组产生胸膜粘连在初期较硝酸银组快 ,到第 4周 ,滑石粉浆组粘连积分显著高于滑石粉浆组 ;硝酸银组 2 4h胸液量多于滑石粉浆组 ;两组肺组织内ICAM 1和NF κB活性表达随着注入硬化剂的时间延长而逐渐增加 ,其活性均在注入硬化剂后开始增高 ,第 2周时达到高峰值 ,到第 4周时降至正常水平 ,且肺组织内ICAM 1和NF κB活性有明显的相关性。结论　　0 .1 %硝酸银 1ml产生胸膜固定术的效果好于 2 0 0mg/kg滑石粉 ,胸膜固定术的主要机制是无菌性炎症反应以及炎性细胞的粘附过程 ,NF κB和ICAMObjective To study the mechanisms of experimental pleurodesis in rats induced by silver nitrate or talc.Methods Adult Sprague Dawley rats were randomily divided into two experimental groups: group A received 1ml of 0.1% silver nitrate, group T received 200mg/kg of talc slurry in 1ml intrapleurally. Six rats in each group were killed at 1, 4, 7, 14d and 28d after intrapleural injection. The NF κB activation and ICAM 1 expression of the experimental lung tissues were examined by immunohistochemistry and image analysis.Results The mean±SEM gross pleurodesis score in the rats that received silver nitrate was (3.3±0.2), which was significantly higher than the score of (1.8±0.1) in the rats that received talc. The mean gross pleurodesis score was significantly higher at each of the observation times( P <0.05), except at the first seven days, in the rats that received silver nitrate. The NF κB activation and ICAM 1 expression were both positive staining in the cytoplasm for each observation times of two groups. The ICAM 1 expression was positively correlated with the NF κB activation in lung tissues.Conclusion The intrapleural injection of 1ml of 0.1% silver nitrate produces a better pleurodesis than does the intrapleural injection of 200mg/kg of talc slurry in rats. The mechanisms responsible for the pleurodesis is that the inflammatory reaction to the administration of sclerosing agent. The up regulation of NF κB activation and ICAM 1 expression is important in the process of pleurodesis.

关 键 词：胸膜固定术 硝酸银 滑石粉 粘连机制 

分 类 号：R655.2[医药卫生—外科学]