本文關(guān)鍵詞： 再灌注損傷 肺損傷 炎性反應(yīng) 迷走神經(jīng)　出處：《解放軍醫(yī)學(xué)雜志》2017年07期 　論文類型：期刊論文

【摘要】：目的觀察雙側(cè)迷走神經(jīng)切除對(duì)大鼠肺缺血再灌注損傷(LIRI)導(dǎo)致的炎癥反應(yīng)的影響。方法 SD大鼠24只,隨機(jī)分為假手術(shù)組(S組)、缺血再灌注組(IR組)和雙側(cè)迷走神經(jīng)切斷合并缺血再灌注組(NIR組),每組8只。于缺血前、再灌注0.5h及再灌注4h抽取動(dòng)脈血進(jìn)行血?dú)夥治?觀察動(dòng)脈血氧分壓(Pa O2)及肺泡動(dòng)脈氧分壓差(A-a DO2)的變化。實(shí)驗(yàn)結(jié)束時(shí)取左肺測(cè)量肺組織的濕/干重比(W/D),于光學(xué)顯微鏡下觀察缺血再灌注后肺的病理學(xué)改變,采用ELISA檢測(cè)肺組織勻漿中腫瘤壞死因子-α(TNF-α)、白細(xì)胞介素-10(IL-10)含量及髓過(guò)氧化物酶(MPO)活性等炎性指標(biāo)的水平。結(jié)果與S組比較,IR組Pa O2明顯降低,A-a DO2明顯升高,W/D及肺組織勻漿中TNF-α、IL-10含量和MPO活性明顯增加,肺組織炎性細(xì)胞浸潤(rùn)、肺泡腔紅細(xì)胞增多、肺泡破壞及組織水腫明顯(P0.05)。與IR組相比,NIR組Pa O2進(jìn)一步降低,肺組織炎性反應(yīng)及病理學(xué)損傷更加嚴(yán)重(P0.05),但A-a DO2無(wú)明顯變化。結(jié)論切斷雙側(cè)迷走神經(jīng)可加重大鼠肺缺血再灌注損傷,提示迷走神經(jīng)完整性在LIRI的炎性反應(yīng)調(diào)節(jié)中具有重要作用。
[Abstract]:Objective to observe the effect of bilateral vagotomy on inflammation induced by lung ischemia-reperfusion injury in rats. The rats were randomly divided into sham operation group (group S) and ischemia reperfusion group (group IR) and bilateral vagotomy combined with ischemia reperfusion group (n = 8). Arterial blood was extracted for blood gas analysis before ischemia, 0.5 h after reperfusion and 4 h after reperfusion. The changes of arterial partial pressure of oxygen (PaO2) and alveolar arterial oxygen pressure difference (A-a DO2) were observed. At the end of the experiment, the left lung was taken to measure the wet / dry weight ratio of lung tissue (W / D), and the pathological changes of the lung after ischemia reperfusion were observed under optical microscope. ELISA was used to detect the contents of tumor necrosis factor- 偽 (TNF- 偽), interleukin-10 (IL-10) and the activity of myeloperoxidase (MPO) in lung homogenate. Results compared with S group, Pao _ 2 in IR group significantly decreased the level of TNF- 偽 -TNF- 偽, interleukin-10 IL-10 and the activity of myeloperoxidase (MPO). Results compared with S group, Pao _ 2 in IR group was significantly lower than that in S group. The content of TNF- 偽 IL-10 and the activity of MPO in the homogenate were significantly increased. Pulmonary inflammatory cells infiltration, alveolar erythrocyte proliferation, alveolar destruction and tissue edema were significantly increased (P0.05). Compared with IR group, Pao _ 2 in NIR group was further decreased. The inflammatory reaction and pathological injury of lung tissue were more serious than that of P0.05, but A-a DO2 had no obvious change. Conclusion bilateral vagotomy can aggravate lung ischemia-reperfusion injury in rats, suggesting that vagus nerve integrity plays an important role in the regulation of inflammatory response of LIRI.
【作者單位】： 重慶醫(yī)科大學(xué)附屬第一醫(yī)院麻醉科;四川大學(xué)華西醫(yī)院麻醉科;
【基金】：國(guó)家自然科學(xué)基金(81170077) 國(guó)家衛(wèi)生部臨床重點(diǎn)�？平ㄔO(shè)項(xiàng)目(財(cái)社[2011]170號(hào)) 重慶市醫(yī)學(xué)重點(diǎn)學(xué)科建設(shè)項(xiàng)目(渝衛(wèi)科教[2007]2號(hào))~~
【分類號(hào)】：R614

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