中华胸心血管外科杂志
中華胸心血管外科雜誌
중화흉심혈관외과잡지
Chinese Journal of Thoracic and Cardiovascular Surgery
2014年
1期
33-37
,共5页
高铭鑫%李海涛%张帆%白辰%于洋
高銘鑫%李海濤%張帆%白辰%于洋
고명흠%리해도%장범%백신%우양
体外循环%肺损伤%细胞凋亡%超微结构%抗肿瘤坏死因子抗体
體外循環%肺損傷%細胞凋亡%超微結構%抗腫瘤壞死因子抗體
체외순배%폐손상%세포조망%초미결구%항종류배사인자항체
Cardiopulmonary bypass%Lung injury%Apoptosis%Ultra-structure%Anti-tumor necrosis factor antibody
目的 探讨肺动脉灌注抗肿瘤坏死因子-α抗体(TNF-α Ab)对体外循环(CPB)肺损伤组织超微结构的影响.方法 选取新西兰白兔40只,数字表法随机分为CPB+单纯肺动脉灌注液组、CPB+肺动脉灌注TNF-α Ab组、单纯CPB组和单纯开胸组.测定各组围CPB期血浆TNF-α、中性粒细胞含量及氧合指数；取肺组织样本,电镜观察其超微结构,并检测肺组织含水量、TNF-α mRNA、Bcl-2、Bax表达和Bcl-2/Bax及凋亡指数变化情况.结果 TNF-α Ab可明显抑制肺源性TNF-α表达和释放,减少CPB期间中性粒细胞在肺内的聚集,降低肺含水量,提高氧合指数,并减少肺组织细胞凋亡发生,降低肺泡上皮细胞Bax蛋白表达,减轻Bcl-2蛋白表达下降,且TNF-α Ab组肺组织病理形态学改变较轻.结论 肺动脉灌注TNF-α Ab能明显减轻炎性肺损伤及由Bcl-2/Bax凋亡途径引起的肺组织超微结构损伤.
目的 探討肺動脈灌註抗腫瘤壞死因子-α抗體(TNF-α Ab)對體外循環(CPB)肺損傷組織超微結構的影響.方法 選取新西蘭白兔40隻,數字錶法隨機分為CPB+單純肺動脈灌註液組、CPB+肺動脈灌註TNF-α Ab組、單純CPB組和單純開胸組.測定各組圍CPB期血漿TNF-α、中性粒細胞含量及氧閤指數；取肺組織樣本,電鏡觀察其超微結構,併檢測肺組織含水量、TNF-α mRNA、Bcl-2、Bax錶達和Bcl-2/Bax及凋亡指數變化情況.結果 TNF-α Ab可明顯抑製肺源性TNF-α錶達和釋放,減少CPB期間中性粒細胞在肺內的聚集,降低肺含水量,提高氧閤指數,併減少肺組織細胞凋亡髮生,降低肺泡上皮細胞Bax蛋白錶達,減輕Bcl-2蛋白錶達下降,且TNF-α Ab組肺組織病理形態學改變較輕.結論 肺動脈灌註TNF-α Ab能明顯減輕炎性肺損傷及由Bcl-2/Bax凋亡途徑引起的肺組織超微結構損傷.
목적 탐토폐동맥관주항종류배사인자-α항체(TNF-α Ab)대체외순배(CPB)폐손상조직초미결구적영향.방법 선취신서란백토40지,수자표법수궤분위CPB+단순폐동맥관주액조、CPB+폐동맥관주TNF-α Ab조、단순CPB조화단순개흉조.측정각조위CPB기혈장TNF-α、중성립세포함량급양합지수；취폐조직양본,전경관찰기초미결구,병검측폐조직함수량、TNF-α mRNA、Bcl-2、Bax표체화Bcl-2/Bax급조망지수변화정황.결과 TNF-α Ab가명현억제폐원성TNF-α표체화석방,감소CPB기간중성립세포재폐내적취집,강저폐함수량,제고양합지수,병감소폐조직세포조망발생,강저폐포상피세포Bax단백표체,감경Bcl-2단백표체하강,차TNF-α Ab조폐조직병리형태학개변교경.결론 폐동맥관주TNF-α Ab능명현감경염성폐손상급유Bcl-2/Bax조망도경인기적폐조직초미결구손상.
Objective To study the effect of intra-pulmonary arterial anti-tumor necrosis factor-α antibody(TNF-α Ab) on ultra-structure of lung after cardiopulmonary bypass (CPB).Methods Forty New Zealand rabbits were selected and randomly divided into four groups:group Ⅰ-Ⅲ underwent CPB; group Ⅳ only received open chest operation.In the group Ⅱ,rabbit TNF-α Ab(27 ng/kg) was dropped into the pulmonary artery when the aorta was clamped and CPB continued 30 minute.Pulmonary arterial perfusion was given to the group I instead.Blood TNF-α and neutrophils count from right and left atrium and oxygenation index in the four groups were determined perioperatively.Lung water content,TNF-αmessenger RNA,Bcl-2 protein,Bax protein,Bcl-2/Bax,apoptosis index and pathomorphological change were measured in the lung tissues.Results TNF-α Ab can restrain leukocyte accumulation and reduce releasing of TNF-α in the lung and improve oxygenation index.Moreover,TNF-α Ab can reduce the expression of Bax on alveolar epithelial cells and alleviate the decreasing of the expression of Bcl-2.It can also reduce the occurrence of apoptosis and attenuate pathomorphological changes in the lung tissue.Conclusion Intra-pulmonary arterial antitumor necrosis factor-α antibody markedly lessens the injury of inflammatory reaction and ultra-structure of lung after CPB via Bcl-2/Bax pathway.
