中国危重病急救医学
中國危重病急救醫學
중국위중병급구의학
CHINESE CRITICAL CARE MEDICINE
2008年
10期
621-624,插3
,共5页
林英%朱曦%和宇%汪宗昱%曹旭光
林英%硃晞%和宇%汪宗昱%曹旭光
림영%주희%화우%왕종욱%조욱광
去甲肾上腺素%内毒素血症%白细胞介素-6%肺损伤,急性%肺水肿
去甲腎上腺素%內毒素血癥%白細胞介素-6%肺損傷,急性%肺水腫
거갑신상선소%내독소혈증%백세포개소-6%폐손상,급성%폐수종
norepinephrine%endotoxemia%interleukin-6%acute lung injury%pulmonary edema
目的 研究颈脊髓切断对内毒素血症大鼠急性肺损伤的影响及可能机制.方法 72只SD大鼠随机分为3组:正常对照组(NC组,8只),内毒素血症组(ET组,32只)及内毒素血症+颈脊髓切断组(TCSC组,32只),后两组按不同时间点(3、6、12和48 h)又分为4个亚组,每个亚组8只.静脉注射脂多糖(LPS)10 mg/kg制备内毒素血症模型.TCSC组注射LPS前切断大鼠颈7脊髓.在不同时间点采血,并留取肺组织.采用高效液相色谱仪-电化学检测法和酶联免疫吸附法(ELISA)分别测定血浆去甲肾上腺素(NE)和白细胞介素-6(IL-6)的浓度;用血气分析仪检测动脉血氧分压(PaO2);观察各组大鼠肺组织病理学改变及肺湿/干重(W/D)比值.结果 TCSC组6、12和48 h血浆NE浓度、肺W/D比值较ET组均显著降低,PaO2较ET组显著升高,差异均有统计学意义(P均<0.05);TCSC组肺损伤程度减轻;3、6、12和48 h血浆IL-6均明显低于ET组(P均<0.05).相关性分析显示,血浆NE与IL-6浓度呈显著正相关(r=0.458,P<0.05),与PaO2呈显著负相关(r=0.528,P<0.05).结论 切断大鼠颈脊髓后造成去交感神经支配可能通过抑制肾上腺素能受体的过度激活而减轻内毒素血症大鼠急性肺损伤的程度,继而改善肺的氧合.
目的 研究頸脊髓切斷對內毒素血癥大鼠急性肺損傷的影響及可能機製.方法 72隻SD大鼠隨機分為3組:正常對照組(NC組,8隻),內毒素血癥組(ET組,32隻)及內毒素血癥+頸脊髓切斷組(TCSC組,32隻),後兩組按不同時間點(3、6、12和48 h)又分為4箇亞組,每箇亞組8隻.靜脈註射脂多糖(LPS)10 mg/kg製備內毒素血癥模型.TCSC組註射LPS前切斷大鼠頸7脊髓.在不同時間點採血,併留取肺組織.採用高效液相色譜儀-電化學檢測法和酶聯免疫吸附法(ELISA)分彆測定血漿去甲腎上腺素(NE)和白細胞介素-6(IL-6)的濃度;用血氣分析儀檢測動脈血氧分壓(PaO2);觀察各組大鼠肺組織病理學改變及肺濕/榦重(W/D)比值.結果 TCSC組6、12和48 h血漿NE濃度、肺W/D比值較ET組均顯著降低,PaO2較ET組顯著升高,差異均有統計學意義(P均<0.05);TCSC組肺損傷程度減輕;3、6、12和48 h血漿IL-6均明顯低于ET組(P均<0.05).相關性分析顯示,血漿NE與IL-6濃度呈顯著正相關(r=0.458,P<0.05),與PaO2呈顯著負相關(r=0.528,P<0.05).結論 切斷大鼠頸脊髓後造成去交感神經支配可能通過抑製腎上腺素能受體的過度激活而減輕內毒素血癥大鼠急性肺損傷的程度,繼而改善肺的氧閤.
목적 연구경척수절단대내독소혈증대서급성폐손상적영향급가능궤제.방법 72지SD대서수궤분위3조:정상대조조(NC조,8지),내독소혈증조(ET조,32지)급내독소혈증+경척수절단조(TCSC조,32지),후량조안불동시간점(3、6、12화48 h)우분위4개아조,매개아조8지.정맥주사지다당(LPS)10 mg/kg제비내독소혈증모형.TCSC조주사LPS전절단대서경7척수.재불동시간점채혈,병류취폐조직.채용고효액상색보의-전화학검측법화매련면역흡부법(ELISA)분별측정혈장거갑신상선소(NE)화백세포개소-6(IL-6)적농도;용혈기분석의검측동맥혈양분압(PaO2);관찰각조대서폐조직병이학개변급폐습/간중(W/D)비치.결과 TCSC조6、12화48 h혈장NE농도、폐W/D비치교ET조균현저강저,PaO2교ET조현저승고,차이균유통계학의의(P균<0.05);TCSC조폐손상정도감경;3、6、12화48 h혈장IL-6균명현저우ET조(P균<0.05).상관성분석현시,혈장NE여IL-6농도정현저정상관(r=0.458,P<0.05),여PaO2정현저부상관(r=0.528,P<0.05).결론 절단대서경척수후조성거교감신경지배가능통과억제신상선소능수체적과도격활이감경내독소혈증대서급성폐손상적정도,계이개선폐적양합.
Objective To investigate the effects of transection of cervical spinal cord (TCSC) on acute lung injury (ALI) and its potential mechanism in rat. Methods Seventy-two rats were randomly divided into three groups: normal control group (NC, n=8), endotoxemia group (ET, n=32) and endotoxemia with TCSC group (TCSC, n=32), and the latter two groups were divided into four subgroups respectively according to different time intervals (n=8). Endotoxemia model was established by injecting lipopolysaccharide (LPS, 10 mg/kg) intravenously, and the spinal cord at 7th cervical spine of rats was transected in TCSC group. Samples of blood and lung were collected at different time intervals. The plasma levels of norepinephrine (NE) and interleukin-6 (IL-6) were measured by high performance liquid chromatography (HPLC) and enzyme-lined immunosorbent assay (ELISA) respectively, and arterial blood oxygen pressure (PaO2) was determined by blood-gas analyser. The changes in histopathology and lung wet/dry weight (W/D) ratio were also observed in every group. Results The changes in the levels of NE and lung W/D ratio of the TCSC group was significantly decreased than those of ET group, but PaO2 of TCSC group was increased obviously than that of ET group (all P<0.05), and the degree of lung injury was less intensive in the TCSC group. At all the time points, the level of IL-6 of TCSC group was lower compared with ET group (all P<0.05). The results of correlation analysis suggested that there was a positive correlation between plasma NE and IL-6 concentration (r=0.458, P<0.05), a negative correlation between NE and PaO2 (r=0.528, P<0.05). Conclusion Sympathectomy as a result of TCSC at 7th cervcal spine may palliate the degree of ALI and improve oxygenation in rats with endotoxemia by inhibiting excessive activation of adrenoceptor.
