中华烧伤杂志
中華燒傷雜誌
중화소상잡지
16
2014年
3期
203-207
,共5页
张杨杨%邱啸臣%周国勇%刘真%常娜%贾赤宇
張楊楊%邱嘯臣%週國勇%劉真%常娜%賈赤宇
장양양%구소신%주국용%류진%상나%가적우
脂多糖类%急性肺损伤%乌司他丁%320排CT
脂多糖類%急性肺損傷%烏司他丁%320排CT
지다당류%급성폐손상%오사타정%320배CT
Lipopolysaccharides%Acute lung injury%Ulinastatin%320-slice CT
目的 了解雾化吸入乌司他丁(UTI)对急性肺损伤(ALI)兔的早期作用,以及320排CT的早期诊断价值. 方法 将18只无特殊病原体级新西兰兔按照随机数字表法分为正常对照组、LPS致伤组及UTI治疗组,各6只,后2组兔给予0.8 mg/kg LPS(浓度为0.16 mg/mL,一次性给予15 mL)建立兔ALI模型,正常对照组兔同法给予等量生理盐水.UTI治疗组兔于伤后30 min起雾化吸入UTI 10 min,LPS致伤组和正常对照组兔同法雾化吸入生理盐水.2组致伤兔均于伤后6、24 h行320排CT全肺灌注扫描.伤后24 h麻醉2组致伤兔取心脏血分离血清,采用ELISA法检测血清TNF-α、IL-1β和IL-6水平;随后于该时相点行肺组织大体及组织病理学观察,测定肺湿干质量比,采用RT-PCR法测定肺组织中TNF-α、IL-1β和IL-6的mRNA水平.正常对照组兔于相同时相点进行相应检测.对数据行单因素方差分析、LSD检验. 结果 LPS致伤组兔伤后6、24 h的灌注图像差异大,UTI治疗组兔相同时相点的灌注图像差异较LPS致伤组轻微,正常对照组兔灌注图像差异不明显.3组兔血清中TNF-α、IL-1β和IL-6水平比较,差异明显(F值为843.896～2 564.336,P值均小于0.001).UTI治疗组血清中TNF-α、IIL-1 β和IL-6水平分别为(225±9)、(190±8)、(227 ±6) pg/mL,低于LPS致伤组[(710 ±25)、(306 ±16)、(422±16) pg/mL,P值均小于0.001].UTI治疗组兔肺出血、水肿程度均较LPS致伤组减轻;组织病理学观察结果显示,UTI治疗组兔肺泡壁结构破坏程度、肺泡腔出血及炎性细胞浸润均较LPS致伤组减轻.与正常对照组比较,LPS致伤组兔肺湿干质量比明显增高(P ＜0.001);UTI治疗组兔虽较正常对照组升高(P＜0.001),但明显低于LPS致伤组(P＜0.001).3组兔肺组织中的TNF-α、IL-1β和IL-6 mRNA水平比较,差异均有统计学意义(F值为24.700～69.538,P值均小于0.001).UTI治疗组兔肺组织中的TNF-α、IL-1β和IL-6 mRNA水平分别为(31.4±2.7)、(21.2±3.3)、(13.9±2.4) pg/mL,明显低于LPS致伤组[(58.5±10.0)、(35.1±5.1)、(20.7±3.2) pg/mL,P值均小于0.001]. 结论 采用雾化吸入UTI的治疗方式可有效减轻ALI兔的肺水肿及出血,并抑制炎症反应.320排CT灌注成像可用于肺损伤早期检测.
目的 瞭解霧化吸入烏司他丁(UTI)對急性肺損傷(ALI)兔的早期作用,以及320排CT的早期診斷價值. 方法 將18隻無特殊病原體級新西蘭兔按照隨機數字錶法分為正常對照組、LPS緻傷組及UTI治療組,各6隻,後2組兔給予0.8 mg/kg LPS(濃度為0.16 mg/mL,一次性給予15 mL)建立兔ALI模型,正常對照組兔同法給予等量生理鹽水.UTI治療組兔于傷後30 min起霧化吸入UTI 10 min,LPS緻傷組和正常對照組兔同法霧化吸入生理鹽水.2組緻傷兔均于傷後6、24 h行320排CT全肺灌註掃描.傷後24 h痳醉2組緻傷兔取心髒血分離血清,採用ELISA法檢測血清TNF-α、IL-1β和IL-6水平;隨後于該時相點行肺組織大體及組織病理學觀察,測定肺濕榦質量比,採用RT-PCR法測定肺組織中TNF-α、IL-1β和IL-6的mRNA水平.正常對照組兔于相同時相點進行相應檢測.對數據行單因素方差分析、LSD檢驗. 結果 LPS緻傷組兔傷後6、24 h的灌註圖像差異大,UTI治療組兔相同時相點的灌註圖像差異較LPS緻傷組輕微,正常對照組兔灌註圖像差異不明顯.3組兔血清中TNF-α、IL-1β和IL-6水平比較,差異明顯(F值為843.896～2 564.336,P值均小于0.001).UTI治療組血清中TNF-α、IIL-1 β和IL-6水平分彆為(225±9)、(190±8)、(227 ±6) pg/mL,低于LPS緻傷組[(710 ±25)、(306 ±16)、(422±16) pg/mL,P值均小于0.001].UTI治療組兔肺齣血、水腫程度均較LPS緻傷組減輕;組織病理學觀察結果顯示,UTI治療組兔肺泡壁結構破壞程度、肺泡腔齣血及炎性細胞浸潤均較LPS緻傷組減輕.與正常對照組比較,LPS緻傷組兔肺濕榦質量比明顯增高(P ＜0.001);UTI治療組兔雖較正常對照組升高(P＜0.001),但明顯低于LPS緻傷組(P＜0.001).3組兔肺組織中的TNF-α、IL-1β和IL-6 mRNA水平比較,差異均有統計學意義(F值為24.700～69.538,P值均小于0.001).UTI治療組兔肺組織中的TNF-α、IL-1β和IL-6 mRNA水平分彆為(31.4±2.7)、(21.2±3.3)、(13.9±2.4) pg/mL,明顯低于LPS緻傷組[(58.5±10.0)、(35.1±5.1)、(20.7±3.2) pg/mL,P值均小于0.001]. 結論 採用霧化吸入UTI的治療方式可有效減輕ALI兔的肺水腫及齣血,併抑製炎癥反應.320排CT灌註成像可用于肺損傷早期檢測.
목적 료해무화흡입오사타정(UTI)대급성폐손상(ALI)토적조기작용,이급320배CT적조기진단개치. 방법 장18지무특수병원체급신서란토안조수궤수자표법분위정상대조조、LPS치상조급UTI치료조,각6지,후2조토급여0.8 mg/kg LPS(농도위0.16 mg/mL,일차성급여15 mL)건립토ALI모형,정상대조조토동법급여등량생리염수.UTI치료조토우상후30 min기무화흡입UTI 10 min,LPS치상조화정상대조조토동법무화흡입생리염수.2조치상토균우상후6、24 h행320배CT전폐관주소묘.상후24 h마취2조치상토취심장혈분리혈청,채용ELISA법검측혈청TNF-α、IL-1β화IL-6수평;수후우해시상점행폐조직대체급조직병이학관찰,측정폐습간질량비,채용RT-PCR법측정폐조직중TNF-α、IL-1β화IL-6적mRNA수평.정상대조조토우상동시상점진행상응검측.대수거행단인소방차분석、LSD검험. 결과 LPS치상조토상후6、24 h적관주도상차이대,UTI치료조토상동시상점적관주도상차이교LPS치상조경미,정상대조조토관주도상차이불명현.3조토혈청중TNF-α、IL-1β화IL-6수평비교,차이명현(F치위843.896～2 564.336,P치균소우0.001).UTI치료조혈청중TNF-α、IIL-1 β화IL-6수평분별위(225±9)、(190±8)、(227 ±6) pg/mL,저우LPS치상조[(710 ±25)、(306 ±16)、(422±16) pg/mL,P치균소우0.001].UTI치료조토폐출혈、수종정도균교LPS치상조감경;조직병이학관찰결과현시,UTI치료조토폐포벽결구파배정도、폐포강출혈급염성세포침윤균교LPS치상조감경.여정상대조조비교,LPS치상조토폐습간질량비명현증고(P ＜0.001);UTI치료조토수교정상대조조승고(P＜0.001),단명현저우LPS치상조(P＜0.001).3조토폐조직중적TNF-α、IL-1β화IL-6 mRNA수평비교,차이균유통계학의의(F치위24.700～69.538,P치균소우0.001).UTI치료조토폐조직중적TNF-α、IL-1β화IL-6 mRNA수평분별위(31.4±2.7)、(21.2±3.3)、(13.9±2.4) pg/mL,명현저우LPS치상조[(58.5±10.0)、(35.1±5.1)、(20.7±3.2) pg/mL,P치균소우0.001]. 결론 채용무화흡입UTI적치료방식가유효감경ALI토적폐수종급출혈,병억제염증반응.320배CT관주성상가용우폐손상조기검측.
Objective To study the early effects of ulinastatin (UTI) by aerosol inhalation on rabbits with acute lung injury induced by LPS,and to observe the early diagnostic value of 320-slice CT.Methods According to the random number table,18 specific pathogen free New Zealand white rabbits were divided into normal control group,group LPS,and group UTI,with 6 rabbits in each group.Rabbits in group LPS and group UTI were given 15 mL lipopolysaccharide (0.16 mg/mL,in the dose of 0.8 mg/kg) to reproduce acute lung injury model.Rabbits in normal control group were given equal volume of normal saline.Rabbits in UTI group were treated with UTI by aerosol inhalation for 10 min from 30 min after injury,while those in the other two groups received normal saline by aerosol inhalation.Rabbits in group LPS and group UTI were scanned by 320-slice CT at post injury hour (PIH) 6 and 24.After anesthesia,heart blood of rabbits in group LPS and group UTI was collected for determination of serum levels of TNF-α,IL-1β,and IL-6 by ELISA at PBH 24.At PBH 24,lung tissue samples were harvested for gross observation and histomorphological observation,measurement of wet to dry weight ratio,and detection of mRNA expressions of TNF-α,IL-1 β,and IL-6 with RT-PCR.Above-mentioned indexes were detected in rabbits of normal control group at the same time point.Data were processed with one-way analysis of variance and LSD test.Results (1) CT perfusion (CTP) image.The difference in CTP image of rabbits in group LPS between PBH 6 and PBH 24 was obvious,while that of rabbits in group UTI and normal control group was slight and not obvious respectively.(2) There were statistically significant differences in the serum levels of TNF-α,IL-1β,and IL-6 of rabbits among the three groups (with F values from 843.896 to 2 564.336,P values below 0.001).The serum levels of TNF-α,IL-1β,and IL-6 in group UTI were respectively (225 ±9),(190 ±8),(227 ± 6) pg/mL,and they were significantly lower than those in group LPS [(710 ±25),(306 ± 16),(422 ± 16) pg/mL,with P values below 0.001].(3) Gross observation.In group UTI,the degrees of pulmonary edema and pneumorrhagia of rabbits were lower than those in group LSP.(4) Histological observation.The damage to alveolar wall in group UTI was milder,and alveolar space hemorrhage and inflammatory cell infiltration were significantly less intense as compared with those in group LPS.(5) Compared with that in normal control group,the wet to dry weight ratio of lung tissue was increased in group LPS (P ＜0.001).The wet to dry weight ratio of lung tissue in group UTI was significantly higher than that in normal control group but lower than that in group LPS (P values below 0.001).(6) There were statistically significant differences in mRNA levels of TNF-α,IL-1 β,and IL-6 in lung tissue of rabbits among three groups (with F values from 24.700 to 69.538,P values below 0.001).The mRNA levels of TNF-α,IL-1 β,and IL-6 in lung tissue of rabbits in group UTIwere respectively (31.4 ±2.7),(21.2 ±3.3),(13.9 ±2.4) pg/mL,which were significantly lower than those in group LPS [(58.5 ± 10.0),(35.1 ± 5.1),(20.7 ± 3.2) pg/mL,P values below 0.001].Conclusions UTI by aerosol inhalation can mitigate pulmonary edema and hemorrhage and inhibit inflammatory response.320-slice CT may be used for detection of early lung injury.
