中华临床医师杂志（电子版）
中華臨床醫師雜誌（電子版）
중화림상의사잡지（전자판）
CHINESE JOURNAL OF CLINICIANS(ELECTRONIC VERSION)
2013年
7期
2986-2990
,共5页
麻醉%乌司他丁%烫伤%肺损伤
痳醉%烏司他丁%燙傷%肺損傷
마취%오사타정%탕상%폐손상
Anesthesia%Ulinastatin%Burns%Ventilator-induced lung injury
目的探讨重度烫伤后麻醉时乌司他丁预处理对机械通气造成的肺组织损伤是否具有保护作用。方法90只Wistar大鼠，随机分为3组，对照组30只，全麻组30只，乌司他丁组30只。建立大鼠重度烫伤模型后，对照组不进行机械通气，全麻组和乌司他丁组机械通气1 h（乌司他丁组通气前接受乌司他丁预处理）。通过观察肺组织大体标本，HE染色观察肺部病理学改变，电镜观察组织超微结构改变，评估肺系数，免疫组织化学染色检测肺组织细胞因子TNF-α、IFN-γ、IL-2的表达水平来检测重度烫伤后，乌司他丁对机械通气造成的肺损伤是否具有保护作用。结果对照组和全麻组大鼠两肺明显水肿，可见出血灶，切面疏松、肿胀；乌司他丁组大鼠两肺充血水肿相对温和。 HE染色可见乌司他丁组肺组织病变轻于全麻组。电镜下：对照组和全麻组肺组织细胞器破坏严重；乌司他丁组相应改变较轻。对比肺系数发现乌司他丁组肺系数与全麻组相比显著下降。免疫组织化学结果显示乌司他丁预处理后肺组织表达TNF-α、IL-2、IFN-γ的强度较全麻组显著降低。结论乌司他丁对重度烫伤大鼠全麻时机械通气所导致的肺损伤具有保护作用。这种保护作用可能与乌司他丁降低细胞因子TNF-α、IFN-γ、IL-2的表达水平有关。
目的探討重度燙傷後痳醉時烏司他丁預處理對機械通氣造成的肺組織損傷是否具有保護作用。方法90隻Wistar大鼠，隨機分為3組，對照組30隻，全痳組30隻，烏司他丁組30隻。建立大鼠重度燙傷模型後，對照組不進行機械通氣，全痳組和烏司他丁組機械通氣1 h（烏司他丁組通氣前接受烏司他丁預處理）。通過觀察肺組織大體標本，HE染色觀察肺部病理學改變，電鏡觀察組織超微結構改變，評估肺繫數，免疫組織化學染色檢測肺組織細胞因子TNF-α、IFN-γ、IL-2的錶達水平來檢測重度燙傷後，烏司他丁對機械通氣造成的肺損傷是否具有保護作用。結果對照組和全痳組大鼠兩肺明顯水腫，可見齣血竈，切麵疏鬆、腫脹；烏司他丁組大鼠兩肺充血水腫相對溫和。 HE染色可見烏司他丁組肺組織病變輕于全痳組。電鏡下：對照組和全痳組肺組織細胞器破壞嚴重；烏司他丁組相應改變較輕。對比肺繫數髮現烏司他丁組肺繫數與全痳組相比顯著下降。免疫組織化學結果顯示烏司他丁預處理後肺組織錶達TNF-α、IL-2、IFN-γ的彊度較全痳組顯著降低。結論烏司他丁對重度燙傷大鼠全痳時機械通氣所導緻的肺損傷具有保護作用。這種保護作用可能與烏司他丁降低細胞因子TNF-α、IFN-γ、IL-2的錶達水平有關。
목적탐토중도탕상후마취시오사타정예처리대궤계통기조성적폐조직손상시부구유보호작용。방법90지Wistar대서，수궤분위3조，대조조30지，전마조30지，오사타정조30지。건립대서중도탕상모형후，대조조불진행궤계통기，전마조화오사타정조궤계통기1 h（오사타정조통기전접수오사타정예처리）。통과관찰폐조직대체표본，HE염색관찰폐부병이학개변，전경관찰조직초미결구개변，평고폐계수，면역조직화학염색검측폐조직세포인자TNF-α、IFN-γ、IL-2적표체수평래검측중도탕상후，오사타정대궤계통기조성적폐손상시부구유보호작용。결과대조조화전마조대서량폐명현수종，가견출혈조，절면소송、종창；오사타정조대서량폐충혈수종상대온화。 HE염색가견오사타정조폐조직병변경우전마조。전경하：대조조화전마조폐조직세포기파배엄중；오사타정조상응개변교경。대비폐계수발현오사타정조폐계수여전마조상비현저하강。면역조직화학결과현시오사타정예처리후폐조직표체TNF-α、IL-2、IFN-γ적강도교전마조현저강저。결론오사타정대중도탕상대서전마시궤계통기소도치적폐손상구유보호작용。저충보호작용가능여오사타정강저세포인자TNF-α、IFN-γ、IL-2적표체수평유관。
Objective To explore the potential protective effects of ulinastatin on ventilation-induced lung injuries of severe burned rats .Methods Ninety Wistar rats were randomly divided into three experimental groups:control group ( n=30 ) , ventilation group ( n=30 ) and ventilation-ulinastatin group ( n=30 ) .After establishing the severe burn model , the rats of latter two groups were mechanically ventilated for 1 hour with or without the pre-treatment of ulinastatin .The lung injury was evaluated by pathological changes ,lung index and the expression level of cytokines including TNF-α,IL-2,and IFN-γat 2 hours,6 hours and 12 hours post-ventilation.The samples of lung tissue at the last time point ( 12 hours ) were used for both HE staining and electron microscopy analysis . Results The lung tissues of the control and ventilation groups exhibited markedly pulmonary edema and scattered hemorrhagic foci .In contrast , ventilation-ulinastatin group demonstrated milder pulmonary edema .HE staining revealed that the pathological changes of ventilation-ulinastatin group were milder than ventilation group .Under electron microscopy ,severe organelle destruction was noted for the lung tissue of control group and ventilation group . In contrast,ventilation-ulinastatin group demonstrated milder pathological changes .Pulmanary index showed that the value of ventilation-ulinastatin group decreased significantly compared with ventilation group .Immunohistochemical staining demonstrated lower expression of TNF-α, IL-2, IFN-γin ventilation-ulinastatin group compared with ventilation group .Conclusions Ulinastatin attenuated ventilation-induced lung injury in a severe burn model of rat . The protective effects of ulinastatin maybe related to the capacity of ulinastatin to reduce the expression of cytokines including TNF-α,IL-2,and IFN-γ.
