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1、烏司他丁對(duì)膿毒癥大鼠急性肺損傷保護(hù)作用研究2007年12月第1卷第1期試刊(1ainJhlDis(He(~cVersion),I)ecen-k~2D7,Vol1,No.1烏司他丁對(duì)膿毒癥大鼠急性肺損傷保護(hù)作用研究李文華宋志芳單慧敏【摘要】目的探討與比較烏司他丁(u1,I)和糖皮質(zhì)激素(Gc)對(duì)膿毒癥性急性肺損傷(ALI)保護(hù)作用.方法采用盲腸結(jié)扎穿孔(CLP)制作sD大鼠膿毒癥ALI模型,隨機(jī)分Au組,GC治療(GC)和UTI治療(UTI)組,成模后3h,6h,12h開(kāi)腹抽血行動(dòng)脈血?dú)夥治?提取支氣管肺泡灌洗液(BALF)檢測(cè)總蛋白(TP),
2、總磷脂(TPL),飽和磷脂酰膽堿(DSPC)含量,測(cè)定肺組織濕/干重(W/D)比值和肺組織勻漿中髓過(guò)氧化物酶(MPO),丙二醛(MDA)含量,血漿中腫瘤壞死因子(TNF—ot),白介素-6(IL-6)含量,觀察與比較各組肺組織病理改變.結(jié)果uT1組PaCO,PaO,HCO一,BE與GC組差異無(wú)統(tǒng)計(jì)學(xué)差異(P>0.05),但高于ALI組(P<0.05);兩組W/D均明顯低于ALI組(P<0.01),BALF中TP顯著低于ALI組(P<0.01),TPL和DSPC/TPL高于ALI組(P<0.05,0.01),但兩組
3、間無(wú)顯著差異(P>0.05);兩組肺組織勻漿中MPO,MDA含量均明顯低于Au組(P<0.01),UTI組MPO含量還明顯高于GC組(P<0.05);兩組血漿TNF—ot,IL-6水平均低于ALI組(P<0.01),UTI組IL-6高于GC組(P<0.05);兩組病理變化均較Au組輕(P<0.01).結(jié)論uTl能改善缺氧,過(guò)度通氣和酸中毒,減輕肺水腫和肺組織病理?yè)p傷,具有抗氧化和抑制炎性細(xì)胞因子釋放作用,其抗炎作用與GC相似.【關(guān)鍵詞】急性肺損傷;膿毒癥;烏司他丁;糖皮質(zhì)激素中圖法分類(lèi)號(hào):R631;R563
4、;R977.1文獻(xiàn)標(biāo)識(shí)碼:AProtectiveeffectofulinastatinonacutelunginjuryduetosepsisinratsLIWenhua,SONGZhi一ng,SHANHuimin(AdultICU,XinhuaHospital,SchoolofMedwine,ShanghaiJiaotongUniversity,Shanghai200092,China)【Abstract】ObjectiveToevaluatetheprotectiveeffectofulinastatin(UTI)onacutelungi
5、njury(ALI)inratmodelinducedbysepsiswithintra?abdominalinfectionandcomparewithglucocorticoid(GC)fortheiranti—inflammatoryeffect.MethodsALImodelwasestablishedbycecalligationandpuncture(CLP)inSDrats,whichwererandomlydividedintoALI,GCandUTIgroupsaccordingtotreatmentbyGCorUTI.Al
6、lofthemweresacrificedat3,6,12hafterCLP.Thenarterialbloodgaseswereanalyzed,andbronchoalveolarlavagefluid(BALF)wascollectedformeasurementofconcentrationoftotalprotein(rI'P),totalphospholipids(TPL),anddesaturatedphosphatidylcholine(DSPC).Meanwhilethewet/drylungweightratio(W/D)
7、wasmeasuredandveinbloodwascollectedfordeterminationoftheconcentrationsoftumormeerosisfactor—d(TNF?0【)andinterleukin-6(IL-6).Malondia1dehyde(MDA)andmyeloperoxidase(MPO)inlungtissuesweredetected.Thepathologicchangesoftheirlungswerealsoexaminedbyopticalmicroscopy.ResultsCompar
8、edwiththoseintheALIgroups,PaCO2,HCO3一,BEandPaO2weremoresignificantlyimprovedintheU
