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1、乌司他丁对脓毒症大鼠急性肺损伤保护作用研究2007年12月第1卷第1期试刊(1ainJhlDis(He(~cVersion),I)ecen-k~2D7,Vol1,No.1乌司他丁对脓毒症大鼠急性肺损伤保护作用研究李文华宋志芳单慧敏【摘要】目的探讨与比较乌司他丁(u1,I)和糖皮质激素(Gc)对脓毒症性急性肺损伤(ALI)保护作用.方法采用盲肠结扎穿孔(CLP)制作sD大鼠脓毒症ALI模型,随机分Au组,GC治疗(GC)和UTI治疗(UTI)组,成模后3h,6h,12h开腹抽血行动脉血气分析,提取支气管肺泡灌洗液(BALF)检测总蛋白(TP),
2、总磷脂(TPL),饱和磷脂酰胆碱(DSPC)含量,测定肺组织湿/干重(W/D)比值和肺组织匀浆中髓过氧化物酶(MPO),丙二醛(MDA)含量,血浆中肿瘤坏死因子(TNF—ot),白介素-6(IL-6)含量,观察与比较各组肺组织病理改变.结果uT1组PaCO,PaO,HCO一,BE与GC组差异无统计学差异(P>0.05),但高于ALI组(P<0.05);两组W/D均明显低于ALI组(P<0.01),BALF中TP显着低于ALI组(P<0.01),TPL和DSPC/TPL高于ALI组(P<0.05,0.01),但两组
3、间无显着差异(P>0.05);两组肺组织匀浆中MPO,MDA含量均明显低于Au组(P<0.01),UTI组MPO含量还明显高于GC组(P<0.05);两组血浆TNF—ot,IL-6水平均低于ALI组(P<0.01),UTI组IL-6高于GC组(P<0.05);两组病理变化均较Au组轻(P<0.01).结论uTl能改善缺氧,过度通气和酸中毒,减轻肺水肿和肺组织病理损伤,具有抗氧化和抑制炎性细胞因子释放作用,其抗炎作用与GC相似.【关键词】急性肺损伤;脓毒症;乌司他丁;糖皮质激素中图法分类号:R631;R563
4、;R977.1文献标识码: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
