徐志礼,何先弟.不同潮气量通气对内毒素肺损伤大鼠Th1/Th2平衡的影响[J].内科急危重症杂志,2016,22(1):
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| DOI： |
| 中文关键词: 急性肺损伤 内毒素 辅助性T淋巴细胞 潮气量 机械通气 |
| 英文关键词:Acute lung injury Lipopolysaccharide Helper T lymphocytes Tidal volume Mechanical ventilation |
| 基金项目:安徽省教育厅资助项目 |
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| 中文摘要: |
| 目的 探讨内毒素肺损伤Thl/Th2平衡变化及不同潮气量通气对内毒素肺损伤大鼠Thl/Th2平衡的影响。方法 健康大鼠32只随机分成4组：生理盐水正常对照A组、内毒素肺损伤非机械通气B组、内毒素肺损伤＋小潮气量C组、内毒素肺损伤＋传统潮气量D组。监测平均动脉压(MAP)、心率(HR)，计算氧合指数（OI），检测PBMC中IFN-γ、IL-4浓度水平并计算IFN-γ/IL-4。取右肺中叶计算肺组织湿干比值(W/D)；观察右肺下叶肺组织病理变化；分析支气管肺泡灌洗液(BALF)中白细胞(WBC)与中性粒细胞(PMN)。结果 1. B、C、D组OI、W/D及病理学变化符合急性肺损伤表现；2. B组IFN-γ/IL-4比值明显高于A组；C组IFN-γ/IL-4比值明显低于B组；D组IFN-γ/IL-4比值明显高于B组；3. B组肺W/D及BALF中WBC、PMN计数明显高于A组；C组肺W/D及BALF中WBC、PMN计数明显低于B组；D组肺W/D及BALF中WBC、PMN计数明显高于B组。结论 1.注射LPS可成功复制大鼠急性肺损伤动物模型；2.内毒素致大鼠肺损伤早期，其PBMC中IFN-γ和IL-4浓度增加，IFN-γ/IL-4升高，Thl/Th2失衡；3.传统潮气量机械通气可加重内毒素肺损伤大鼠炎症反应，使肺损伤早期大鼠Th1/Th2失衡加剧；4.保护性通气策略的小潮气量机械通气可减轻内毒素肺损伤大鼠PMN在肺内“扣押”，改善Th1/Th2失衡状态。 |
| 英文摘要: |
| Objective To investigate Thl/Th2 balance in rats with LPS induced lung injury, and to approach the influence of mechanical ventilation with small and traditional tidal volume on Th1/Th2 balance in rats with LPS induced lung injury. Methods 32 healthy adult SD rats were random divided into four groups(n=8): normal sodium contrast group(A), LPS induced acute lung injury with non-mechanical ventilation group(B), LPS induced acute lung injury with small tidal volume ventilation group(C) and LPS induced acute lung injury with traditional tidal volume ventilation group(D). Monitored the mean arterial pressure, heart rate, calculated their oxygenation index, measure IFN-γ, IL-4 concentration of PBMC and calculated the ratio of IFN-γ/IL-4. The right lung median lobe was obtained to calculate W/D, and examination of lung tissues that was from the right lung inferior lobe, WBC and PMN were measured in the BALF. Results 1. of B, C, D group, the performances indicators such as OI, W/D and pathological changes were in line with acute lung injury. 2. Compared with A group, IFN-γ/IL-4 of B group markedly increased respectively. Compared with B group, IFN-γ/IL-4 of C group were markedly lower respectively. Compared with B group, IFN-γ/IL-4 of D group were markedly increased respectively. 3. Compared with A group, the lung W/D and the WBC, PMN in BALF of B group increased markedly respectively. Compared with B group, the ratio of lung W/D and the WBC, PMN in BALF of C group were markedly decreased respectively. Compared with B group, the ratio of W/D and the WBC, PMN in BALF of D group was markedly increased respectively. Conclusions: 1. Injection of LPS in rats can successfully reproduced animal models of ALI. 2. IFN-γ and IL-4 concentration in PBMC, IFN-γ/IL-4 ratio increased in the rats induced with LPS early, so Thl/Th2 imbalances. 3.Mechanical ventilation with traditional tidal volume can exacerbate lung injury in the rats induced with LPS during inflammatory response, so that aggravate Th1/Th2 imbalances of the early lung injury in rats. 4. Mechanical ventilation with small tidal volume as a protective ventilation strategy of endotoxin lung injury in rats can lighten the PMN keep in the lung, may correct the Th1/Th2 imbalance. |
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