本文關鍵詞： 兔煤塵肺 巨噬細胞 肺纖維化 HRCT　出處：《山西醫(yī)科大學》2013年碩士論文　論文類型：學位論文

【摘要】：目的： 通過動態(tài)觀察兔煤塵肺病程過程，探索兔煤塵肺各期AM（肺泡巨噬細胞）和IM（間質(zhì)巨噬細胞）含量的變化趨勢與肺纖維化進展的關系。 方法： 1、實驗動物采用40只健康雄性日本大耳白兔，，隨機分為5組，每組任選5只作為實驗對象煤塵組，剩余每組另外3只作為對照組，麻醉狀態(tài)下通過新生兒喉鏡引導分別對煤塵組兔氣管內(nèi)一次性注入100mg/ml的煤塵懸液（灌注量2ml/kg)；對照組采用同樣的方法注入同等劑量的生理鹽水。 2、分別于2周、1月、2月、3月、5月時對相應的各組兔子進行HRCT掃描分析，通過對實驗兔子肺的影像學表現(xiàn)來判斷其肺纖維化進程。 3、每一期實驗兔子掃描后處死，取出肺組織，用機械法分離AM（肺泡巨噬細胞），用酶消化法分離IM（間質(zhì)巨噬細胞），并用流式細胞儀對其含量定量分析并與HRCT改變對照。 4、實驗數(shù)據(jù)經(jīng)SPSS13.0統(tǒng)計軟件采用秩和檢驗和Spearman秩相關分析進行統(tǒng)計，以α=0.05作為檢驗水準，P＜0.05差異有統(tǒng)計學意義。 結果： 煤塵組兔HRCT動態(tài)觀察發(fā)現(xiàn)肺病變明顯的進展，2周-1月HRCT顯示肺內(nèi)主要出現(xiàn)支氣管血管束異常、磨玻璃樣密度影、小葉間隔增厚及結節(jié)影，3月-5月HRCT顯示煤塵肺主要出現(xiàn)異常擴張的支氣管、肺蜂窩狀改變及肺不張等HRCT表現(xiàn)，流式細胞儀測定AM（肺泡巨噬細胞）及IM（間質(zhì)巨噬細胞）全部觀察各個時間點，所有實驗組統(tǒng)計結果顯示：煤塵組各個時間點的AM%差別有統(tǒng)計學意義(H=23.077，P0.001)，對照組各個時期的AM%差別沒有統(tǒng)計學意義（H=1.885，P=0.757）。煤塵組各個時間點的IM%差別有統(tǒng)計學意義(H=22.607，P0.001)，對照組各個時期的IM%差別沒有統(tǒng)計學意義（H=3.290，P=0.511）。AM%與HRCT嚴重程度的相關系數(shù)rs=0.746；IM%與HRCT嚴重程度的相關系數(shù)rs=-0.776；AM%與IM%的相關系數(shù)rs=-0.968。HRCT表現(xiàn)與各期AM（肺泡巨噬細胞）及IM（間質(zhì)巨噬細胞）含量均具有相關性；生理鹽水對照組各期無上述改變。 結論： HRCT能動態(tài)反應各期兔煤塵肺的影像學變化，各期病程在HRCT上可觀察到；兔煤塵肺模型的各期HRCT表現(xiàn)和AM（肺泡巨噬細胞）及IM（間質(zhì)巨噬細胞）含量存在相關性。AM（肺泡巨噬細胞）及IM（間質(zhì)巨噬細胞）含量之間存在相關性，從而證明肺巨噬細胞含量與HRCT表現(xiàn)具有較大相關性。
[Abstract]:Objective:. Through dynamic observation of the process of coal pneumoconiosis in rabbits, the relationship between the changes of AM (alveolar macrophage) and IMM (interstitial macrophage) and the progression of pulmonary fibrosis in each stage of rabbit coal pneumoconiosis was investigated. Methods:. 1. Forty healthy male Japanese white rabbits were randomly divided into 5 groups, 5 rabbits in each group as experimental objects, and 3 rabbits in each group as control group. Under anesthesia, 100 mg / ml coal dust suspension was injected into the trachea of the coal dust group by laryngoscope respectively (2 ml / kg / kg) and the control group was injected with the same dose of normal saline by the same method. 2. Two weeks, January, February, March, March, respectively, HRCT scanning analysis was performed on each group of rabbits, and the pulmonary fibrosis progression was judged by imaging findings of the lungs of experimental rabbits. 3. The rabbits were killed after each phase of scanning, and the lung tissue was taken out. The alveolar macrophages were separated by mechanical method, and the interstitial macrophages were separated by enzyme digestion. The contents of the macrophages were quantitatively analyzed by flow cytometry and compared with the changes of HRCT. 4. The experimental data were statistically analyzed by SPSS13.0 software using rank sum test and Spearman rank correlation analysis. There was significant difference in the test level between 偽 -0. 05 and Spearman (P < 0. 05). Results:. The dynamic observation of HRCT in the coal dust group revealed the obvious progress of pulmonary lesions from 2 weeks to January HRCT showed the main abnormalities of bronchovascular bundle in the lung, and the ground-glass-like density shadow. The interlobular septal thickening and nodular shadow were observed. From March to May, HRCT showed that coal pneumoconiosis mainly showed abnormal dilation of bronchi, honeycomb changes of lung, atelectasis and other HRCT manifestations. Flow cytometry was used to measure AM (alveolar macrophage) and IMM (interstitial macrophage) at all time points. The results of all experimental groups showed that the difference of AM% at different time points in coal dust group was statistically significant, while that in control group was not significant at every stage. The difference of IM% in coal dust group at different time points was statistically significant. There was no significant difference in IM% between different periods of exposure group. The correlation coefficient between HRCT severity and HRCT severity was not statistically significant. The correlation coefficient between IM% and HRCT severity was r sl0. 776% and IM%. Rs=-0.968.HRCT expression and the expression of AM (alveolar macrophage) and IMM (mesenchymal macrophage) in all stages were not statistically significant. There was a correlation between the cell content and the cell content. No above changes were found in the saline control group. Conclusion:. HRCT could dynamically reflect the imaging changes of rabbit coal pneumoconiosis at different stages, and the course of disease in each stage could be observed on HRCT. There was a correlation between HRCT findings and the contents of AM (alveolar macrophage) and IMM (interstitial macrophage) in each stage of rabbit coal pneumoconiosis model. There was a correlation between the contents of AM (alveolar macrophage) and IMM (interstitial macrophage). It was proved that the content of pulmonary macrophages was correlated with HRCT.
【學位授予單位】：山西醫(yī)科大學
【學位級別】：碩士
【學位授予年份】：2013
【分類號】：R135.2;R816.41

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