地塞米松对大鼠通气机所致肺损伤的防护作用

Protective effects of dexamethasone on ventilator-induced lung injury in an rat model

  • 摘要: 目的:研究地塞米松对大鼠通气机所致肺损伤(VILI)的防护作用。方法:将30只健康雄性SD大鼠随机分为3组,实施麻醉和气管切开术后,接受两种通气策略通气,通气时间均为4h。A组为对照组( n=10,VT =8m/l kg),B组为致伤组,接受大潮气量通气( n=10,VT =40m/l kg),C组( n=10,VT =40m/l kg)为地塞米松防治组。每小时行1次动脉血气分析。行支气管肺泡灌洗液(BALF)中白细胞和中性粒细胞计数,测定右肺W/D值、BALF中总蛋白含量、BALF和血中TNF-α、IL-1β水平,并观察肺脏的组织病理学变化。结果:通气4h后,B组动脉血氧分压(PaO2)较A、C组显著下降,BALF中有大量的白细胞浸润。B组BALF中总蛋白含量、右肺W/D值较A、C组显著升高。B组BALF中TNF-α、IL-1β水平显著升高,C组较B组显著降低。组织病理学显示B组较A、C组肺脏内有更多的白细胞浸润和肺泡壁结构的破坏。结论:结果表明一系列炎症和炎症前反应参与了VILI的发生机制,地塞米松通过其抗炎作用对大鼠VILI模型具有较明显的防护作用。

     

    Abstract: Objective:To investigate the protective effects of dexamethasone on ventilator-induced lung injury(VILI)in an rat model. Methods:We established an rat model of VILI with a large tidal volume of 40m/l kg.After anesthesia was administered and tracheotomy was performed,30healthy male Sprague-Dawley rats were randomly divided into three groups to receive two ventilation protocols for 4h: group A was served as control groups (n=10,VT =8m/l kg),group B received large tidal volume ventilation (n=10,VT =40m/l kg),group C(n=10) received the same tidal volume as group B with pre-treatment of dexamethasone.Arterial blood gases were measured every one hour.Total white blood cells (WBCs) in BALF were counted.Wet to dry right lung weight ratio (W/D),the concentrations of total protein in bronchoalveolar lavage fluid (BALF),TNF-α,IL-1βlevels in BALF and blood.Lung histopathology was assessed among three groups.Results:After 4hrs mechanical ventilation,arterial oxygen pressure(PaO2) was significantly lower in group B than A and C.A large guantity of WBCs were found in BALF of group B.The total protein contents in BALF,W/D of right lung were significantly higher in group B than A and C.The levels of TNF-α,IL-1β in BALF were increased in group B,while decreased in group C.Histopathologic findings demonstrated more infiltrating WBCs ,destructive change of the alveolar wall in group B than other groups.Conclusions: These results suggest that a series of proinflammatory,inflammatory reactions may be involved in the course of VILI.Dexamethasone has obvious protective effects on VILI through its ant-i inflammation potents.

     

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