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  本文選題：氣管內(nèi)給藥　切入點：氣管黏膜　出處：《福建醫(yī)科大學》2012年碩士論文　論文類型：學位論文

【摘要】：目的：研究氣管內(nèi)注射阿米卡星對Wistar大鼠氣管黏膜的超微結構和病理的影響，并利用電鏡和光鏡分別觀察氨溴索注射液干預處理后對阿米卡星組大鼠氣管黏膜變化的影響，進一步了解埅痰藥氨溴索在黏液纖毛系統(tǒng)中的作用。 材料與方法：將30只雄性Wistar大鼠隨機分為2組：阿米卡星組、氨溴索干預組各15只。對照組（阿米卡星組）及氨溴索干預組，各15只大鼠。各組大鼠麻醉后均經(jīng)氣管穿刺注入阿米卡星0.252mL/kg，氨溴索干預組在氣管注入阿米卡星后立即腹腔注射氨溴索注射液70mg/kg,分別于給藥后第2、4、8、24、48小時處死大鼠，解剖分離氣管及肺組織，掃描電鏡觀察支氣管黏膜的超微結構變化特點，用Image-ProPlus6.0圖像分析軟件對每張掃描電鏡圖片進行半定量分析纖毛受損面積，并觀察右肺組織病理變化。 結果：1、電鏡下阿米卡星組大鼠氣管黏膜均出現(xiàn)不同程度的纖毛受損，表現(xiàn)為排列紊亂、倒伏、粘著、變短，部分斷裂缺失，伴不同程度的黏液分泌增加。光鏡下阿米卡星組大鼠肺部出現(xiàn)纖毛紊亂，黏液分泌增加、杯狀細胞增多，部分支氣管肺組織內(nèi)可見炎癥細胞浸潤。2、阿米卡星組比氨溴索干預組大鼠纖毛受損面積增加（P0.01）。3、在各個相應的時間點，阿米卡星組纖毛受損面積均大于氨溴索干預組（P0.01）；氨溴索組纖毛結構恢復較好。4、阿米卡星組受損面積組內(nèi)比較中，第2h、4h受損面積相比無顯著差異（P0.05），第2h、4h明顯高于第8h（P0.01），第8h大于第24h（P0.01），第24h高于第48h（P0.01）；氨溴索干預組受損面積組內(nèi)比較中，第4h和2h相比有減少趨勢（P0.01），第4h明顯高于8h（P0.01），，第8h明顯高于24h（P0.01），第24h明顯高于48h（P0.01）。5、兩組纖毛受損面積組間相互比較中，第2h阿米卡星組受損面積大于氨溴索干預組（P0.01）；第4h、8h、24h、48h阿米卡星組受損面積大于氨溴索干預組（P0.01）。 結論：1、氣管內(nèi)局部注射阿米卡星，均可對大鼠氣管黏膜表面纖毛超微結構和肺臟細支氣管黏膜造成不同程度的急性損傷，但損傷具有可逆性，隨時間增加自我修復。2、氨溴索干預后氣管內(nèi)注入阿米卡星大鼠雖然纖毛結構受損，但程度較阿米卡星組明顯減輕，病理提示肺部炎癥細胞少見，提示氨溴索注射液可促進纖毛結構修復，并減輕肺部炎癥反應，縮短恢復時間。
[Abstract]:Objective: to study the effects of intratracheal injection of amikacin on the ultrastructure and pathology of tracheal mucosa in Wistar rats. To further understand the role of ambroxol in mucociliary system. Materials and methods: thirty male Wistar rats were randomly divided into two groups: amikacin group, ambroxol intervention group (15 rats), control group (amikacin group) and ambroxol intervention group (ambroxol group). The rats in each group were injected with amikacin 0.252 mL / kg by trachea puncture after anesthesia, and ambroxol injection of 70 mg / kg was injected intraperitoneally in the ambroxol intervention group immediately after trachea injection. The trachea and lung tissues were dissected and the ultrastructural changes of bronchial mucosa were observed by scanning electron microscope (SEM). The damage area of cilium was semi-quantitatively analyzed by Image-ProPlus6.0 image analysis software, and the pathological changes of right lung tissue were observed. Results under the electron microscope, the mucous membrane of the trachea of amicacin group showed various degree of cilia damage, such as disorder of arrangement, lodging, adhesion, shortening, partial rupture and deletion. With the increase of mucus secretion in different degree. Under light microscope, amikacin group had ciliated disorder, increased mucus secretion and goblet cells. Inflammatory cell infiltration could be seen in some bronchopulmonary tissues. Amikacin group could increase the damaged area of cilium in ambroxol group compared with ambroxol group. The damaged area of cilia in amikacin group was larger than that in ambroxol intervention group (P 0.01), the cilium structure of ambroxol group recovered better than that of ambroxol group, and that of amikacin group was better than that of ambroxol group. There was no significant difference in the damaged area between the 2nd hour and the 4th hour (P 0.05), but at the second hour, it was significantly higher than that in the 8th hour (P 0.01), in the 8th hour was higher than that in the 24 h (P 0.01), and in the 24 h was higher than that in the 48 h (P 0.01), and in the ambroxol intervention group, the damaged area was higher than that in the control group. At the 4th hour and the 2nd hour, there was a decreasing trend of P0.01U, the 4th hour was significantly higher than the 8h P0.01U, the 8h was significantly higher than the 24h P0.01U, the 24h was significantly higher than the 48hu P0.01U 路5. in the comparison between the two groups, the area of the damaged cilium in the two groups was significantly higher than that in the control group. The damaged area of amikacin group at 2 h was larger than that of ambroxol intervention group (P 0.01), and the damage area of amikacin group was larger than that of ambroxol intervention group (P 0.01). ConclusionAmikacin injected locally into trachea can cause different degrees of acute injury to the surface ciliated ultrastructure of trachea mucosa and bronchiolus mucosa in rats, but the injury is reversible. After the intervention of ambroxol, although the cilium structure was damaged, the degree of amikacin group was much less than that of amikacin group, and the pathological results showed that the inflammatory cells of lung were rare. The results suggest that ambroxol injection can promote ciliated structure repair, alleviate pulmonary inflammation and shorten recovery time.
【學位授予單位】：福建醫(yī)科大學
【學位級別】：碩士
【學位授予年份】：2012
【分類號】：R562

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本文編號：1631951