摘要
目的构建水下爆炸致兔急性心肺损伤模型,通过观察各组模型动脉血氧分压及心肺组织湿干重比值的差异,评估乌司他丁的治疗效果。通过分析乌司他丁治疗下模型血清中的炎性细胞因子水平的变化,初步探讨乌司他丁治疗水下爆炸急性心肺损伤的可能机制。方法将40只新西兰雄兔随机分为正常对照组、爆炸损伤组、低剂量乌司他丁组和高剂量乌司他丁组。利用水下爆炸装置对爆炸损伤组、低剂量乌司他丁组和高剂量乌司他丁组造成急性心肺损伤,并在致伤后即刻对低剂量乌司他丁组和高剂量乌司他丁组分别进行2.5万U/kg和10万U/kg的乌司他丁治疗。检测实验兔在爆炸后4 h、12 h、24 h的动脉血氧分压(PaO 2)及血清肿瘤坏死因子α(TNF-α)、白细胞介素8(IL-8)和中性粒细胞弹性蛋白酶(NE)的水平。爆炸24 h后测量家兔的心肺组织湿干重比值。结果动脉血氧分压检测结果提示:爆炸损伤组实验兔在致伤后4 h、12 h、24 h的PaO 2分别为(84.97±6.41)、(79.13±9.92)、(78.24±3.53)mmHg,与正常对照组4 h(92.15±4.13)、12 h(89.39±7.54)、24 h(90.24±9.33)相比均明显下降(P=0.042,P=0.018,P=0.002),而低剂量和高剂量乌司他丁组并未观测到PaO 2下降。与对照组相比,爆炸损伤组动物的心肌组织和肺组织的湿干重比值均显著升高(P=0.037,P=0.028)。高剂量乌司他丁组的心肌组织湿干重比值明显低于爆炸损伤组(P=0.047)。炎性细胞因子检测结果提示:与爆炸损伤组相比,低剂量乌司他丁组的血清TNF-α含量在爆炸后12 h和24 h均明显降低(P=0.018,P=0.013);高剂量乌司他丁组的血清TNF-α含量也在爆炸后24 h低于爆炸损伤组(P=0.004)。低剂量乌司他丁组和高剂量乌司他丁组的血清NE含量均在爆炸后24 h显著低于爆炸损伤组(P=0.007,P=0.036)。高剂量乌司他丁组的血清IL-8在爆炸后4 h、12 h、24 h均显著低于爆炸损伤组(P=0.024,P=0.007,P=0.011)。结
Objective The model with acute injury of heart and lung induced by underwater explosion was constructed.Ther-apeutic effect wasassessed by observing difference in arterial oxygen partial pressure and the ratio of wet and dry weight in cardiopulmonary tissue.The change of three inflammatory cytokines was investigated after treatment with low-dose and high-dose ulinastatin therapy to explore possible the mechanism.Methods 40 male New-Zealand rabbits were randomly divided into four groups,Normal group,Injury group,Low-dose ulinastatin therapy group and High-dose ulinastatin therapy group.An underwater explosion device was used to cause acute injury of heart and lung to experimental rabbits in Injury group,Low-dose ulinastatin therapy group and High-dose ulinastatin therapy group.Immediately after the injury,25000 U/kg and 100000 U/kg ulinastatin were administered to Low-dose ulinastatin therapy group and High-dose ulinastatin therapy group,respectively.The arterial partial oxygen pressure(PaO 2)and levels of TNF-α,IL-8,and NE in serum were detected at 4 h,12 h,and 24 h after the explosion.The wet-dry weight ratio of heart and lung tissue was measured 24 hours after the explosion.Results The results showed that PaO 2 of rabbits in group I were 84.97±6.41,79.13±9.92,78.24±3.53 mmHg at 4 h,12 h and 24 h after injury,which were significantly lower than group N at 4 h(92.15±4.13),12 h(89.39±7.54),24 h(90.24±9.33)(P=0.042,P=0.018,P=0.002).But,this was not observed in group A and B.Compared with group N,the wet-dry weight ratio of heart and lung tissue in group I were significantly increased(P=0.037,P=0.028).In addition,the wet-dry weight ratio of heart tissue in group B was significantly lower than that in group I(P=0.047).Moreover,compared with the group I,the serum TNF-αlevel in the low-dose treatment group was significantly lower at 12 h and 24 h after the explosion(P=0.018,P=0.013);Similarly,the serum TNF-αlevel in high-dose treatment group was also lower than that in group I at 24 hours after the explosion(P
作者
叶长青
邵先安
王前进
王静
马宏昊
齐晓林
尹纯
YE Chang-qing;SHAO Xian-an;WANG Qian-jin;WANG Jing;MA Hong-hao;QI Xiao-lin;YIN Chun(Department of Cardiovascular Medicine,the 902nd Hospital of PLA Joint Service Support Force,Bengbu 233015,Anhui,China;Department of Modern Mechanics,University of Science and Technology of China,Hefei 230027,Anhui,China;Department of Management,General Hospital of Eastern Theater Command,PLA,Nanjing 210002,Jiangsu,China)
出处
《东南国防医药》
2021年第1期1-5,共5页
Military Medical Journal of Southeast China
基金
南京军区医学重点课题资助项目(14ZD20)。
