西维来斯他对油酸-内毒素介导ALI/ARDS的肺保护作用研究
董晨明2 蔡振刚2
1. 兰州大学第二临床医学院, 2. 兰州大学第二医院ICU
【摘要】 目的: 探讨西维来斯他注射液对油酸-内毒素介导急性肺损伤/急性呼吸窘迫综合征大鼠的肺保护作用。 方法: 采用油酸和内毒素贯序注射制备急性肺损伤/急性呼吸窘迫综合征的动物模型。成年健康SD大鼠48只按随机数字表法分成空白对照组、模型对照组、预处理组和后处理组。各组动物在造模6h后处死并分离肺组织称重，计算肺组织干湿比，行肺组织病理观察，支气管肺泡灌洗液的中性粒细胞计数。采用酶联免疫吸附法测定血清中性粒细胞弹性蛋白酶水平、髓系细胞触发受体-1水平和支气管肺泡组织灌洗液中性粒细胞弹性蛋白酶水平。 结果:与后处理组比较，预处理组血清中性粒细胞弹性蛋白酶、血清髓系细胞触发受体-1和支气管肺泡灌洗液中性粒细胞弹性蛋白酶水平明显下降，差异具有显著性(P<0.05)，支气管肺泡灌洗液中性粒细胞计数和肺组织干湿比也明显降低，差异具有显著性(P<0.05)。结论:中性粒细胞弹性蛋白酶抑制剂西维来斯他注射液对急性肺损伤/急性呼吸窘迫综合征具有肺脏保护作用，预处理比后处理的肺保护作用更明显。
【Abstract】objective: To investigate the protective effects of the sivelestat injection on the lung in rats with ALI/ARDS by sequencely injected oleic acid and endotoxin.Methods:ALI/ARDS model was reproduced in the rats by sequencely injectioning the oleic acid and endotoxin . Fourty-eight heathy adult SD rats were randomly divided into four groups:control group, model control group, Pre-treatment group, Reprocessing group.Animals in each group were sacrificed after 6h modeling and separation of lung tissue weighing, calculation of lung tissue wet and dry ratio of pulmonary pathology observed in bronchoalveolar lavage fluid neutrophil count.Serum levels of neutrophil elastase(NE) and TREM-1 and The BALF of neutrophil elastase(NE) were determined by enzyme linked immunoadsorbent assay(ELISA).Light microscopy was used assess the pathological changes in lung and account the neutrophilic granulocyte in each BALF .ResultsCompared with later treatment group ,serum levels of neutrophil elastase and TREM-1 and bronchoalveolar lavage fluid of was significantly decreased at 6h in Instantly treatment group ,(p<0.05).The counts of neutrophilic granulocytes of bronchoalveolar lavage fluid and the lung wet/dry weights apparently descend,(p<0.05).Conclusion:neutrophil elastase-sivelestat was definitely protective effects on the lung in rats with ALI/ARDS ,especial the instantly treatment .
