CAJ | 학술논문

目的：放射性肺损伤是影响胸部肿瘤放射治疗的最重要因素之一，以明确参芎注射液对放射性肺损伤是否预防及治疗作用，并初步探讨其作用机制。方法：选取体重200±14g成年雄性大鼠105只，分为7组，即正常对照组（N），单独给药组（D），单独照射组（Z），照射10 Gy+给药组（Z10），照射15 Gy+给药组（Z15），照射20 Gy+晚期给药组（照射后4周给药，Z20a），照射20 Gy+早期给药组（照射同时给药，Z20b）。所有药物均经腹腔注射。分别于照射后2、4、6、8、10 W处死大鼠，取血清，应用ELISA法检测TNF-α和TGF-β1，取肺组织制成石蜡切片，HE染色观察病理变化。结果：单纯照射组血清TNF-α和TGF-β1值明显高于其他各组（P<0.01），照射加给药组血浆TNF-α和TGF-β1值高于对照组及单独给药组（P>0.05）；各照射加给药组之间TNF-α和TGF-β1值差异无统计学意义（P>0.05）；大鼠单独照射组，照射2 W后，可见肺脏体积增大，充血水肿，照射后4周，肉眼见肺表面较多点状出血；而给药组肺表面出血点明显减少；参芎组肺组织炎症变化明显好于单独照射组；照射20 Gy大鼠4周后开始给药略好于单独照射组，但差异无统计学意义（P>0.05）；照射4～6周时单纯照射组有大鼠死亡；照射8～10周部分大鼠出现胸腔积液。结论：参芎注射液能预防放射性肺损伤的发生，机理可能与该药物能降低血浆TNF-α和TGF-β1值有关；发生放射性肺炎后给药能减缓症状，但不能逆转放射性肺炎的病理变化。
목적：방사성폐손상시영향흉부종류방사치료적최중요인소지일，이명학삼궁주사액대방사성폐손상시부예방급치료작용，병초보탐토기작용궤제。방법：선취체중200±14g성년웅성대서105지，분위7조，즉정상대조조（N），단독급약조（D），단독조사조（Z），조사10 Gy+급약조（Z10），조사15 Gy+급약조（Z15），조사20 Gy+만기급약조（조사후4주급약，Z20a），조사20 Gy+조기급약조（조사동시급약，Z20b）。소유약물균경복강주사。분별우조사후2、4、6、8、10 W처사대서，취혈청，응용ELISA법검측TNF-α화TGF-β1，취폐조직제성석사절편，HE염색관찰병리변화。결과：단순조사조혈청TNF-α화TGF-β1치명현고우기타각조（P<0.01），조사가급약조혈장TNF-α화TGF-β1치고우대조조급단독급약조（P>0.05）；각조사가급약조지간TNF-α화TGF-β1치차이무통계학의의（P>0.05）；대서단독조사조，조사2 W후，가견폐장체적증대，충혈수종，조사후4주，육안견폐표면교다점상출혈；이급약조폐표면출혈점명현감소；삼궁조폐조직염증변화명현호우단독조사조；조사20 Gy대서4주후개시급약략호우단독조사조，단차이무통계학의의（P>0.05）；조사4～6주시단순조사조유대서사망；조사8～10주부분대서출현흉강적액。결론：삼궁주사액능예방방사성폐손상적발생，궤리가능여해약물능강저혈장TNF-α화TGF-β1치유관；발생방사성폐염후급약능감완증상，단불능역전방사성폐염적병리변화。
Objective:To evaluate whether Salviae Miltiorrhizae Liguspyragine Hydrochloride and Glucose Injection has posi-tive effects on the prevention and treatment of radiation-induced lung injury. The basic function and mechanism of Salviae Miltiorrhi-zae Liguspyragine Hydrochloride and Glucose Injection were also investigated. Methods:A total of 70 adult male rats weighing about 200 g were selected and divided into seven groups. These groups were as follows:1) normal control group (N):rats were injected with 1 ml of normal saline per day;2) single medicine treatment group (D):rats were administered with 1 ml of Salviae Miltiorrhizae Ligus-pyragine Hydrochloride and Glucose Injection per day;3) single irradiation group (Z):rats were exposed to 20 Gy single whole-chest ir-radiation and injected with 1 ml of normal saline per day;4) irradiation with 10 Gy and medicine treatment group (Z10):rats were ex-posed to 10 Gy single whole-chest irradiation and administered with 1 ml of Salviae Miltiorrhizae Liguspyragine Hydrochloride and Glucose Injection per day; 5) irradiation with 15 Gy and medicine treatment group (Z15): rats were exposed to 15 Gy single whole-chest irradiation and administered with 1 ml of Salviae Miltiorrhizae Liguspyragine Hydrochloride and Glucose Injection per day;6) irradiation with 20 Gy and medicine treatment group (Z20a):rats were exposed to 20 Gy single whole-chest irradiation for four weeks, and administered with 1 ml of Salviae Miltiorrhizae Liguspyragine Hydrochloride and Glucose Injection per day;and 7) irradia-tion with 20 Gy and medicine treatment group (Z20b):rats were exposed to 20 Gy single whole-chest irradiation and administered with 1 ml of Salviae Miltiorrhizae Liguspyragine Hydrochloride and Glucose Injection per day. Two rats were selected and sacrificed at the end of two, four, six, eight, and ten weeks of irradiation. Samples of blood and lung tissues in rats were obtained. Results:In the group with single irradiation, the tumor necrosis factor-α (TNF-α) and transforming growth factor-β (TGF-β) levels in plasma of rats were higher than those in the other groups. In the group with irradiation and medicine treatment, the TNF-αand TGF-βlevels in plasma were higher than those in the normal control group and single medicine treatment group. In the group with single irradiation for four weeks,some petechial hemorrhages on the surface of the lung were visible to the naked eye. In the groups with medicine treatment, the petechi-al hemorrhages on the surface of the lung visibly reduced. According to the pathological mechanism of lung tissues, the groups with Sal-viae Miltiorrhizae Liguspyragine Hydrochloride and Glucose Injection exhibited less inflammation than the single irradiation group. Ir-radiation at 20 Gy for four weeks followed by a daily abdominal injection was slightly better than single irradiation, but the effects were not obvious. Conclusion: Salviae Miltiorrhizae Liguspyragine Hydrochloride and Glucose Injection could prevent the occurrence of lung injury by reducing the TNF-αand TGF-βlevels in plasma. After the occurrence of radiation-induced pneumonitis, the application of medicine could not decrease the symptoms.