协和医学杂志

2013, v.4(03) 255-259

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高渗盐溶液对兔肠缺血/再灌注所致肺损伤的保护作用
Protective Effect of Hypertonic Saline Solution on Lung Injury Induced by Intestinal Ischemia-reperfusion in Rabbits

徐军;郑亮亮;刘业成;李毅;朱华栋;郭树彬;于学忠;马遂;
XU Jun,ZHENG Liang-liang,LIU Ye-cheng,LI Yi,ZHU Hua-dong,GUO Shu-bin,YU Xue-zhong,MA Sui Department of Emergency,Peking Union Medical College Hospital,Chinese Academy of Medical Sciences & Peking Union Medical College,Beijing 100730,China

摘要(Abstract):

目的探讨高渗盐溶液(hypertonic saline solution,HS)对肠缺血/再灌注(intestinal ischemia-reperfusion,IIR)所致肺损伤的作用。方法 72只新西兰白兔按随机数字表法分为4组(n=18):空白对照组、IIR组、4%HS治疗组、7.5%HS治疗组。空白对照组采用仅开腹、游离但不阻断肠系膜上动脉的假手术处理;其余实验组采用完全夹闭肠系膜上动脉1h后开放再灌注的方法制备IIR模型,2个治疗组均在肠系膜上动脉开放前5min输注相应浓度的氯化钠溶液。选择缺血前与再灌注后2、4、6h4个时间点取血测定各组肿瘤坏死因子-α(tumor necrosis factor-α,TNF-α)和白细胞介素-10(interleukin-10,IL-10)水平。再灌注后6h每组处死8只动物,取其肺组织测定组织中的髓过氧化物酶(myeloperoxidase,MPO)活性、肺组织湿/干比,光镜下观察病理形态改变。结果 IIR组再灌注后循环中TNF-α和IL-10水平、肺组织MPO活性、肺组织湿/干比以及病理损伤评分均较空白对照组显著升高(P<0.05);2个HS治疗组与IIR组相比,循环中TNF-α和IL-10水平、肺组织MPO活性、肺组织湿/干比以及病理损伤评分均显著下降(P<0.05);而7.5%HS组在4%HS组基础上各指标进一步下降(P<0.05)。结论 HS治疗对IIR所致肺损伤具有保护作用,该效应在一定范围内随着浓度的增加而增强。
Objective To study the effect of hypertonic saline solution ( HS) on lung function in intestinal ischemia-reperfusion ( IIR) models. Methods Totally 72 rabbits were randomly divided into 4 groups ( n = 18) : control group,IIR group,4% HS group,and 7. 5% HS group. The IIR models were produced by clamping super mesenteric artery ( SMA) for 1 hour and declamping SMA for 6 hours in IIR group,4% HS group,and 7. 5% HS group,whereas animals in control group underwent sham operation. The corresponding sodium chloride solution was infused in the 2 treatment groups in 5 minutes before declamping SMA. Before and 2,4,6 hours after IIR,the plasma levels of tumor necrosis factor-α ( TNF-α) and interleukin-10 ( IL-10) were measured. At 6 hours after IIR,8 rabbits in each group were killed to measure the levels of lung water and myeloperoxidase ( MPO) activity in lung tissue. Meanwhile,lung morphological changes were observed under light microscope. Results The plasma TNF-α and IL-10 levels,the levels of lung water and MPO activity in lung tissue,and lung morphological score significantly increased in IIR group when compared with the control group ( P < 0. 05 ) .Compared with the IIR group,the TNF-α levels in plasma,the levels of lung water and MPO activity in lung tissue,and lung morphological score in both two HS groups significantly decreased ( P < 0. 05 ) ,particularly in 7. 5% HS group which was significantly lower than those in the 4% HS group ( P < 0. 05) . Conclusions HS has a protective effect on the lung function during IIR. Such a protective effect increases along with the increase of HS concentration within certain range.

关键词(KeyWords): 肠缺血/再灌注;高渗盐溶液;急性呼吸窘迫综合征
intestine ischemia-reperfusion; hypertonic saline solution; acute respiratory distress syndrome

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作者(Author): 徐军;郑亮亮;刘业成;李毅;朱华栋;郭树彬;于学忠;马遂;
XU Jun,ZHENG Liang-liang,LIU Ye-cheng,LI Yi,ZHU Hua-dong,GUO Shu-bin,YU Xue-zhong,MA Sui Department of Emergency,Peking Union Medical College Hospital,Chinese Academy of Medical Sciences & Peking Union Medical College,Beijing 100730,China

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