CAJ | 학술논문

目的通过观察不同时间段机械通气大鼠肺组织中小窝蛋白-1(caveolin-1,cav-1)的表达水平,探讨cav-1在呼吸机所致肺损伤(VILI)发病中的作用.方法雄性SD大鼠32只,随机分为对照组、通气0.5h组(H-VT0.5h组)、通气1h组(H-VT1h组)和通气2h组(H-VT2h组).采用免疫组织化学染色法测定各组大鼠肺组织cav-1的表达水平,测定其肺湿/干重(W/D)比值和支气管肺泡灌洗液(BALF)中总蛋白含量,并在光镜下观察各组大鼠肺组织的病理学改变.结果 ①肺组织cav-1表达结果显示,H-VT0.5h组和对照组均明显高于H-VT2h组和H-VT1h组(P值均＜0.001),H-VT0.5h组明显高于对照组(P＜0.001),H-VT1h组明显高于H-VT2h组(P＜0.01).②肺组织W/D比值和BALF总蛋白含量测定结果显示,H-VT2h组和H-VT1h组均明显高于对照组和H-VT0.5h组(P值均＜0.001),H-VT2h组明显高于H-VT1h组(P＜0.001),H-VT0.5h组与对照组比较差异无统计学意义(P＞0.05).③肺组织病理学结果显示,随着机械通气时间延长,大鼠肺组织损伤程度呈逐渐加重趋势.结论肺组织cav-1在机械通气不同时间段表达水平明显不同,表现为先增高后降低.提示肺组织cav-1高表达对VILI起一定保护作用；大潮气量机械通气可通过抑制肺组织cav-1表达,诱发和加重肺组织损伤.
목적 통과관찰불동시간단궤계통기대서폐조직중소와단백-1(caveolin-1,cav-1)적표체수평,탐토cav-1재호흡궤소치폐손상(VILI)발병중적작용.방법 웅성SD대서32지,수궤분위대조조、통기0.5h조(H-VT0.5h조)、통기1h조(H-VT1h조)화통기2h조(H-VT2h조).채용면역조직화학염색법측정각조대서폐조직cav-1적표체수평,측정기폐습/간중(W/D)비치화지기관폐포관세액(BALF)중총단백함량,병재광경하관찰각조대서폐조직적병이학개변.결과 ①폐조직cav-1표체결과현시,H-VT0.5h조화대조조균명현고우H-VT2h조화H-VT1h조(P치균＜0.001),H-VT0.5h조명현고우대조조(P＜0.001),H-VT1h조명현고우H-VT2h조(P＜0.01).②폐조직W/D비치화BALF총단백함량측정결과현시,H-VT2h조화H-VT1h조균명현고우대조조화H-VT0.5h조(P치균＜0.001),H-VT2h조명현고우H-VT1h조(P＜0.001),H-VT0.5h조여대조조비교차이무통계학의의(P＞0.05).③폐조직병이학결과현시,수착궤계통기시간연장,대서폐조직손상정도정축점가중추세.결론 폐조직cav-1재궤계통기불동시간단표체수평명현불동,표현위선증고후강저.제시폐조직cav-1고표체대VILI기일정보호작용；대조기량궤계통기가통과억제폐조직cav-1표체,유발화가중폐조직손상.
Objective To observe the expression of the caveolin-1 induced by high tidal volume ventilation in lung tissue of rats during different time periods,and therefore to explore the role of caveolin-1 in ventilator induced lung injury.Methods Thirty two healthy male Sprague-Dawley rats were randomly divided into four groups:control group,ventilation for half an hour group (H-VT0.5h group),ventilation for one hour group (H-VT1h group),and ventilation for two hours group (H-VT2h group).The expression of caveolin-1 in lung tissues of rats was detected by immunohistochemistry.The level of total protein (TP)in bronchoalveolar lavage fluid (BALF) was measured by bicinchoninic acid method.The lung wet/dry weight ratio (W/D) was calculated.The pathological changes of the lungs were observed under light microscope.Results ①The expression of caveolin-1 in lung tissues in H-VT0.5h group and control group was respectively higher than that in H-VT1h group and H-VT2h group (all P ＜0.001),that in H-VT0.5h group was higher than that in control group (P ＜0.001),that in H-VT1h group was higher than that in H-VT2h group (P ＜0.01).②W/D of lung tissues and the level of TP in BALF in H-VT1h group and H VT2h group were respectively higher than those in H-VT0.5h group and control group (all P ＜0.001),those in H-VT2h group were higher than those in H-VT1h group (P ＜ 0.001).There was no statistical difference in W/D and the level of TP in BALF between control group and H-VT0.5h group (P ＞0.05).③Histopatholosical findings under light microscope demonstrated that diffused alveolar damage induced by mechanical ventilation was worse with time.Conclusions With the extension of the duration of mechanical ventilation,the expression of caveolin-1 increases at first,then reduces.The high expression of caveolin 1 plays a protective role in ventilator induced lung injury.The high tidal volume ventilation can induce and aggravate the lung injury by inhibiting the expression of caveolin-1.