金胜,陈军,叶繁,冯丹.机械通气对大鼠照射后肺组织及细胞凋亡的影响[J].中华放射医学与防护杂志,2015,35(5):344-348
机械通气对大鼠照射后肺组织及细胞凋亡的影响
Effect of high volume mechanical ventilation on radiation-induced lung toxicity in rats
投稿时间:2014-04-10  
DOI:10.3760/cma.j.issn.0254-5098.2015.05.006
中文关键词:  机械通气  放射性肺损伤  炎症反应  氧化应激  细胞凋亡
英文关键词:Ventilator  Radiation-induced lung injury  Inflammatory response  Oxidative stress  Apoptosis
基金项目:
作者单位E-mail
金胜 430060 武汉大学人民医院放射科  
陈军 430060 武汉大学人民医院放射科 whuchenjun@163.com 
叶繁 湖北文理学院附属医院襄阳市中心医院麻醉科  
冯丹 华中科技大学同济医学院附属协和医院麻醉科  
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中文摘要:
      目的 通过建立大鼠机械通气及放射性肺损伤动物模型,研究机械通气对放射性肺损伤大鼠肺组织急性炎症、氧化应激及细胞凋亡的影响.方法 40只雄性Sprague-Dawley(SD)大鼠,采用随机数字表法分成4组,每组10只,即健康对照组、照射组、通气组和照射后通气组.观测各组肺组织病理改变;凝胶电泳迁移率实验(EMSA)检测肺组织细胞NF-κB的活性;Western blot检测肺细胞核内NF-κB亚基P65蛋白表达水平;采用DNA断端末端标记(TUNEL)法检测肺细胞的凋亡;同时检测肺湿干重比值(W/D)、髓过氧化物酶(MPO)、丙二醛(MDA)、超氧化物歧化酶(SOD);检测肺灌洗液中总蛋白、白细胞计数的水平.结果 与健康对照组相比,其余3组急性肺损伤(ALI)评分、W/D比值、MPO活性、总蛋白、白细胞计数、凋亡指数(AI)、肺组织MDA值、NF-κB的活性及P65蛋白的表达均显著性增高,差异有统计学意义(q=0.000 32~0.004 81,P<0.05);而SOD值显著下降(q=0.000 18~0.002 53,P<0.05).与照射组和通气组比较,照射后通气组上述指标显著增高(q=0.004 3~0.022 6,P<0.05);SOD值显著下降(q=0.002 9~0.008 3,P<0.05).结论 放射性肺损伤后大潮气量机械通气比正常单纯大潮气量机械通气产生了更加明显的机械通气肺损伤,表现为渗透性肺水肿、急性炎症反应、氧化应激反应的激活以及广泛的肺细胞凋亡.
英文摘要:
      Objective To evaluate the effects of mechanical ventilation on radiation induced lung injuries of apoptosis, acute inflammation, and oxidative stress by establishing a rat mechanical ventilation model and animal model. Methods Totally 40 male Sprague-Dawley(SD) rats were randomly divided into 4 groups with 10 rats in each group: control, radiation alone, high tidal volume ventilation, and high tidal volume ventilation following by radiation. After treatment, the pathological changes in lung tissue were observed, NF-κB activity was detected by electrophoretic mobility shift assay (EMSA), the expression of NF-κB subunit P65 protein level in lung cell nucleus was detected by Western blot, and the apoptosis of lung cells was detected by terminal dexynucleotidyl transferase(TdT)-mediated dUTP nick end labeling (TUNEL) method. The wet to dry weight ratio (W/D) of lung, myeloperoxidase (MPO), malondialdehyde (MDA) and superoxide dismutase (SOD) were detected. In addition, the total protein and white blood cell number in lung lavage fluid were also measured. Results Compared to the control, the acute lung injury (ALI) score, W/D ratio, MPO activity, total protein level, white blood cell number, apoptosis index (AI), lung tissue MDA, NF-κB activity and P65 protein expression were increased significantly (q =0.000 32-0.004 81, P<0.05), while SOD values was decreased significantly (q =0.000 18-0.002 53, P<0.01), in other three groups. Compared with radiation and high tidal volume ventilation group, the above indexes were significantly higher (q =0.004 3-0.022 6, P<0.05) but the SOD value was significantly lower (q =0.002 9-0.008 3, P<0.05) than those in the high tidal volume ventilation plus radiation group. Conclusions High tidal volume ventilation delivered to the radiation group produced more transparent ventilator-induced lung injury (VILI) than the high tidal volume ventilation alone induced VILI including permeable pulmonary edema, acute inflammation, oxidative stress and apoptosis in lung.
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