CAJ | 학술논문

目的了解高频振荡通气(HFOV)及HFOV与肺表面活性物质(PS)联合应用对吸人性损伤家兔肺组织炎性反应的影响.方法将新西兰大白兔24只制成重度蒸气吸入性损伤模型,按随机数字表法分为对照组、HFOV组和HFOV+PS组,每组8只,分别行定容通气、HFOV及HFOV+PS治疗.治疗3.5 h时取各组家兔肺组织标本,行病理学检查及肺损伤评分,检测髓过氧化物酶(MPO)及半胱氨酸天冬氨酸蛋白酶1(caspase-1)活性,测定TNF-α、IL-18、IL-10和IL-13含量及其mRNA的表达情况.结果 (1)各组吸入性损伤家兔肺组织出现不同程度病理学改变,以对照组最明显,HFOV+PS组最轻.对照组、HFOV组、HFOV+PS组肺损伤评分各为(3.71±0.43)、(2.87±0.26)、(2.08±0.28)分,组间两两比较,差异均有统计学意义(P<0.01).(2)HFOV组和HFOV+PS组家兔MPO、caspase-1活性明显低于对照组(P<0.01),并且HFOV+PS组明显低于HFOV组(P<0.05).(3)HFOV组和HFOV+PS组家兔TNF-α、IL-18含量及其mRNA表达量明显低于对照组(P<0.01),IL-10和IL-13含量及其mRNA表达量明显高于对照组(P<0.01);HFOV+PS组这几项指标较HFOV组变化更明显(P<0.05).结论 HFOV能减轻吸入性损伤家兔肺组织炎性反应和肺损伤,联合应用PS效果更佳.
목적 료해고빈진탕통기(HFOV)급HFOV여폐표면활성물질(PS)연합응용대흡인성손상가토폐조직염성반응적영향.방법 장신서란대백토24지제성중도증기흡입성손상모형,안수궤수자표법분위대조조、HFOV조화HFOV+PS조,매조8지,분별행정용통기、HFOV급HFOV+PS치료.치료3.5 h시취각조가토폐조직표본,행병이학검사급폐손상평분,검측수과양화물매(MPO)급반광안산천동안산단백매1(caspase-1)활성,측정TNF-α、IL-18、IL-10화IL-13함량급기mRNA적표체정황.결과 (1)각조흡입성손상가토폐조직출현불동정도병이학개변,이대조조최명현,HFOV+PS조최경.대조조、HFOV조、HFOV+PS조폐손상평분각위(3.71±0.43)、(2.87±0.26)、(2.08±0.28)분,조간량량비교,차이균유통계학의의(P<0.01).(2)HFOV조화HFOV+PS조가토MPO、caspase-1활성명현저우대조조(P<0.01),병차HFOV+PS조명현저우HFOV조(P<0.05).(3)HFOV조화HFOV+PS조가토TNF-α、IL-18함량급기mRNA표체량명현저우대조조(P<0.01),IL-10화IL-13함량급기mRNA표체량명현고우대조조(P<0.01);HFOV+PS조저궤항지표교HFOV조변화경명현(P<0.05).결론 HFOV능감경흡입성손상가토폐조직염성반응화폐손상,연합응용PS효과경가.
Objective To investigate the effects of high frequency oscillatory ventilation (HFOV) and its combination with administration of pulmonary surfaetant (PS) on inflammatory response of lung tissue in rabbits with inhalation injury. Methods Severe steam inhalation injury models were reproduced in 24 New Zealand albino rabbits. They were divided into control group (n = 8) , HFOV group (n = 8) , and HFOV + PS group (n = 8) according to the random number table, and they received ventilation in metered volume, HFOV, and HFOV + PS treatment respectively. Lung tissue samples of rabbits were collected at 3.5 h after treatment for pathological inspection and pulmonary injury score, assay of the activity of my-eloperoxidase (MPO) and cysteinyl aspartate-specific protease 1 (caspase-1), and the determination of the contents of TNF-α, IL-18, IL-10, IL-13 and their mRNA expression. Results Pathological change in dif-ferent degree of rabbit lung tissue in each group were observed, and they were most obvious in the control group, and least in the HFOV + PS group. The lung tissue injury scores of control group, HFOV group, and HFOV + PS group was 3.71 ± 0. 43, 2.87±0. 26, and 2.08±0.28 respectively. The difference between ei-ther two of them were statistically significant (P <0.01). The MPO content and caspase-1 activity of rabbits in HFOV and HFOV + PS groups were obviously lower than those in control group (P < 0, 01), and MPO content and caspase-1 activity of rabbits in HFOV + PS group were obviously lower than those in HFOV group (P <0.05). In HFOV group and HFOV + PS group, the contents of TNF-α, IL-18 and their mRNA ex-pression in lung tissue homogenates were obviously lower than those in control group (P <0. 01) ;while the contents of IL-10, IL-13 and their mRNA expression were obviously higher than those in control group (P < 0.01). Changes in these contents and expression in HFOV + PS group were more obvious than those in HFOV group (P <0.05). Conclusions HFOV can alleviate inflammatory response in rabbit lung tissue and pulmonary injury induced by inhalation injury, and the effect is more obvious when combined with PS.