河北医科大学学报

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甲泼尼龙对盐酸诱导急性肺损伤大鼠的保护作用

  

  1. 1.首都医科大学附属北京世纪坛医院重症医学科,北京 100038;2.北京大学第三医院危重症医学科,北京 100191
  • 出版日期:2016-06-25 发布日期:2017-01-16
  • 作者简介:甄洁(1981-),女,河北涞水人,首都医科大学附属北京世纪坛医院住院医师,医学硕士,从事危重症诊治研究。
  • 基金资助:
    国家自然科学基金(81372043);首都医科大学附属北京世纪坛医院青年博士基金课题项目(2012-QB14)

The protective effects of Methylprednisolone on rats with HClinduced acute lung injury #br#

  1. 1.Department of Intensive Care Unit, Beijing Shijitan Hospital, Capital Medical University, Beijing 100038, China;
    2.Department of Intensive Care Vnit, the Third Hospital of
    Peking University, Beijing 100191, China
  • Online:2016-06-25 Published:2017-01-16

摘要: [摘要] 目的 评价脑脊液细胞学动态监测在中枢神经系统感染性疾病鉴别诊断及疗效判断中的临床意义。
方法 对 117 例中枢神经系统感染性疾病的脑脊液细胞学检测结果进行回顾性分析。结果 117 例患者中,结核性
脑膜炎 70 例( 59.83% ),病 毒性 脑膜 炎 30 例( 25.64% ),化 脓性 脑膜 炎 10 例( 8.55% ),隐球 菌性 脑 膜炎 6 例
(
5.13% ),脑囊虫病 1 例( 0.85% )。结核性脑膜炎的脑脊液细胞学改变主要以混合细胞学反应为主,随着病情的
好转,嗜中性粒细胞逐渐减少,但持续时间较长;化脓性脑膜炎主要以嗜中性粒细胞反应为主,抗感染治疗后,嗜中
性粒细胞在短时间内迅速减少;病毒性脑膜炎主要以淋巴细胞反应为主;隐球菌性脑膜炎通过脑脊液细胞学检测
可直接发现隐球菌,达到病原学诊断;脑囊虫病可见脑脊液中嗜酸性粒细胞增多,杀虫治疗后嗜酸性粒细胞逐渐减
少。结论 结核性脑膜炎是最常见的中枢神经系统感染性疾病;通过脑脊液细胞学的动态监测,对中枢神经系统感
染性疾病的诊断及判断预后有重要的指导作用。

关键词: 急性肺损伤, 甲泼尼龙, 盐酸, 大鼠

Abstract:
[Abstract]  ObjectiveTo investigate the protective effects of different doses of methylprednisolone(MP) on HCLinduced acute lung injury in rats. MethodsA total of 48 male SD rats were divided randomly into four groups according to the random number table method:model group, control group, smalldose MP group and highdose MP group. Each group included 12 rats. The model group were injected with hydrochloric acid(pH=18, 2 mL/kg) by the endotracheal intubation, and the control group were injected with equal volume of normal saline by the endotracheal intubation. The smalldose MP group and highdose MP group were intraperitoneally injected with 5 mg/kg and 40 mg/kg MP after duplicating model. Four hours after duplicating model, the pathological changes of lung tissue were observed under light microscope. The lung wet/dry ratio(W/D) was calculated. Protein concentration, PMN% in bronchoalveloar lavage fluid and the expression of  Na+K+ATPase α1  isoforms mRNA in lung tissues were measured.  ResultsIn the control group, the lung tissue structure was clear, the alveolar septum was uniform, and there was no fibrin exudation and neutrophil infiltration in the alveolar. Model group showed the bronchial epithelial cells, alveolar cavity, a large number of fibrin exudation and edema fluid formation. Compared with model group, there were different degrees of improvement of the lung tissue pathologic characteristics in the smalldose MP group and highdose MP group.  In model group,smalldose MP group and highdose MP group, W/D,protein concentration and PMN% in BALF were significantly increased, the Na+K+ATPase α1  isoforms mRNA expressions were significantly lower. and the protein concentrations in BALF in smalldose MP group and highdose MP group were significantly decreased, compared with control group. The difference was statistically significant (P<001). ConclusionMP can significantly improve lung injury degree of hydrochloric acidinduced acute lung injure model of rats. Smalldose MP has more advantage on lung protection than highdose MP on acute lung injury of rats.

Key words: acute lung injury, methylprednisolone, hydrochloric acid, rats