[1]杨傲,梁毅,袁丹凤,等.不同成熟度肺脏冲击伤后肺泡灌洗液中SP-B等相关指标时间点差异与意义探讨[J].第三军医大学学报,2019,41(05):399-405.
 YANG Ao,LIANG Yi,YUAN Danfeng,et al.Difference and significance of SP-B content in alveolar lavage fluid and other related indexes at same time after blast injury in rabbit lungs with different maturities[J].J Third Mil Med Univ,2019,41(05):399-405.
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不同成熟度肺脏冲击伤后肺泡灌洗液中SP-B等相关指标时间点差异与意义探讨(/HTML )
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《第三军医大学学报》[ISSN:1000-5404/CN:51-1095/R]

卷:
41卷
期数:
2019年第05期
页码:
399-405
栏目:
军事医学
出版日期:
2019-03-15

文章信息/Info

Title:
Difference and significance of SP-B content in alveolar lavage fluid and other related indexes at same time after blast injury in rabbit lungs with different maturities
作者:
杨傲梁毅袁丹凤代维蔡晗孜刘大维周继红游昕
陆军军医大学(第三军医大学)野战外科研究所第四研究室;中国人民解放军第454医院胸外科
Author(s):
YANG Ao LIANG Yi YUAN Danfeng DAI Wei CAI Hanzi LIU Dawei ZHOU Jihong YOU Xin

Department 4, Institute of Surgery Research, Army Medical University (Third Military Medical University), Chongqing, 400042; Department of Thoracic Surgery, No. 454 Hospital of PLA, Nanjing, Jiangsu Province, 210000, China

关键词:
肺冲击伤未成熟肺肺表面活性物质相关蛋白-B病理生理特征
Keywords:
blast lung injury immature lung pulmonary surfactant-associated protein B pathophysiological characteristics
分类号:
R363.27; R655.3; R826
文献标志码:
A
摘要:

目的 探索未成熟肺与成熟肺在重度冲击伤后同一时间点肺泡灌洗液中SP-B含量差异,伤后相关指标变化、特点及意义。方法 4周龄幼年健康新西兰白兔[幼年兔组,雌雄不拘40只,体质量(442.10±55.30)g]与24周龄成年健康新西兰白兔[成年兔组,雌雄不拘40只,体质量(2018.15±145.80)g],采用不同驱动压构建实验动物伤情一致的动物模型(驱动压:幼年兔组4.5 MPa,成年兔组4.0 MPa)。在两组伤情一致情况下分别于伤即刻(0 h),2、4、6、12、24、48、72 h检测肺泡灌洗液中SP-B浓度(ELISA法)、观测动物肺大体解剖和光镜病理、测定肺组织含水量和生理指标等。结果 两组肺损伤程度较为一致(P>0.05),所有时间点幼年兔组SP-B浓度均低于成年兔组(P<0.05)。幼年兔以肺泡壁断裂和损伤居多,成年兔以肺泡及间质内出血及炎症细胞浸润多见。伤后2 h肺含水率(82.68±0.58 vs 81.06±0.34)、伤后0.5 h血氧饱和度(75.00±18.52 vs 42.20±21.84)均为幼年兔高于成年兔(P<0.05)。伤后6 h(36.92±16.01 vs 60.30±12.09)、12 h(31.42±11.30 vs 46.40±14.15)、24 h(29.48±4.76 vs 35.52±9.77)和48 h(25.70±11.66 vs 37.68±9.11)中性粒细胞百分比则为幼年兔组低于成年兔组(P<0.05)。结论 冲击伤后幼年兔未成熟肺与成年兔成熟肺相比肺水肿恢复较快、炎症反应较轻;但SP-B含量较低、合成和分泌功能恢复较慢,可能导致其呼吸功能恢复较慢;从而用以指导不同成熟度肺损伤的临床救治。

 

Abstract:

Objective To explore the difference of SP-B content in alveolar lavage fluid (ALF) between immature lung and mature lung at the same time point after lung blast injury, and investigate the significance and pathophysiological characteristics of related indexes. Methods The experimental animals (both sexes) included 40 healthy young New Zealand  rabbits, weighting 442.10±55.30 g (young rabbit group), and 40 healthy New Zealand rabbits, aged 24 weeks, weighting 2 018.15±145.80 g (adult rabbits group). The experimental model was established under different driving pressures to ensure that the severity of injury was consistent (drive pressure: 4.5 MPa for young rabbit group and 4.0 MPa for adult rabbit group). After injury, the ALF content of SP-B was measured with ELISA at the immediate (0), 2, 4, 6, 12, 24, 48 and 72 h after injury, and the lungs were observed for gross anatomy and pathological changes. The tissue water content and other physiological indicators were determined at the same time. Results The severity of lung injury was consistent between the 2 groups (P>0.05). The SP-B concentration in the young rabbit group was lower than that in the adult rabbit group at all time points (P<0.05); the alveolar wall rupture and injury were more commonly observed in the young rabbits, and the alveolar interstitial hemorrhage and inflammatory cell infiltration were more common in the adult rabbits; the lung water content at 2 h after injury (82.68±0.58 vs 81.06±0.34) and the oxygen saturation at 0.5 h after injury (75.00±18.52 vs 42.20±21.84) were higher in young rabbits group than adult rabbits group (P<0.05). The percentage of neutrophils in the young rabbits group at 6 (36.92±16.01 vs 60.30±12.09), 12 (31.42±11.30 vs 46.40±14.15), 24 (29.48±4.76 vs 35.52±9.77) and 48 h (25.70±11.66 vs 37.68±9.11) after injury were lower than adult rabbits group (P<0.05). Conclusion Compared with mature lungs of adult rabbits after lung blast injury, the immature lungs of young rabbits recover faster and have milder inflammatory reaction, but the SP-B content is lower, the synthesis and secretion function recover slowly, which may lead to the recovery of respiratory function slow. Our results may be used to guide the treatment for injury in immature and mature lungs.

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更新日期/Last Update: 2019-03-05