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表皮生长因子对烟雾吸入性损伤大鼠的治疗作用
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摘要
目的:以烟雾吸入性损伤大鼠为研究对象,在气道中滴入表皮生长因子(epidermal growth factor,EGF),观察不同剂量EGF对大鼠的治疗作用,以确定EGF的用药剂量,并为EGF临床用药方案(药物剂量、用法)的制定提供参考。
     方法:研究分为两部分:1.制作大鼠烟雾吸入性损伤模型:将大鼠随机分为7组——正常对照组,吸入性损伤后1h、6h、12h、24h、48h、72h活杀组,每组6只,在特制装置中烟雾致伤。从大鼠的血气分析,肺系数,大体及病理观察,支气管肺泡灌洗液(bronchoalveolar lavage fluid,BALF)中细胞总数(totalcell count,TC)、巨噬细胞(macrophage,MAC)、中性粒细胞(neutrophil,NEU)、淋巴细胞(lymphocyte,LYM)、红细胞(red blood cell,RBC)、上皮细胞(epithelialcell,EP)分类计数和蛋白浓度等指标多方面评价该模型的致伤效果。2.观察不同剂量EGF对大鼠的治疗效果:将大鼠随机分为4组——对照组、低剂量组(100ug/kg)、中剂量组(150ug/kg)和高剂量组(200ug/kg),气管内分别滴入生理盐水(normal sodium,NS)和不同浓度EGF(50ug/ml、75ug/ml、100ug/ml)2ml/kg,12h后腹腔注射BrdU(100mg/kg),观察吸入性损伤大鼠致伤后72h的血气分析,肺系数(pulmonary index,PI),大体及病理观察,支气管肺泡灌洗液中细胞总数、巨噬细胞、中性粒细胞、淋巴细胞、红细胞、上皮细胞分类计数和蛋白浓度等指标,观察EGF的治疗作用;并进行BrdU免疫组化染色,观察EGF对气道上皮细胞的增殖作用。
     结果:1.本研究制作的大鼠烟雾吸入性损伤的模型致伤情况达到预期结果,多次重复,效果稳定。血气分析显示:PH呈下降趋势,致伤后12h、24h、48h、72h与对照组相比差异非常显著,且24h最为低;PaO_2明显降低,伤后1h与对照组相比即有显著差异直至观察结束;PaCO_2呈上升趋势,致伤后24h、48h、72h与对照组相比差异显著;12h、24h、48h、72h肺系数显著升高,于伤后24h最为明显,之后逐渐降低;支气管肺泡灌洗液中:细胞总数于12h后明显增加;巨噬细胞、红细胞于24h后明显增加:中性粒细胞、淋巴细胞于6h后明显增加;上皮细胞于48h时明显增加;对照组大鼠BALF中蛋白浓度为(11.303±5.634)ug/ml,致伤组呈上升趋势,48h为[46.956±15.175,P<0.05)],72h时为[(60.781±35.354,P<0.01)]。
     2.致伤后气管内滴入生理盐水和不同剂量EGF,结果显示:PH随剂量增加呈上升趋势,与对照组相比中、高剂量组差异显著;PaO_2呈上升趋势,PaCO_2呈下降趋势,与对照组相比中、高剂量组差异显著,其中高剂量组PaO_2差异非常显著。高剂量组与低剂量组相比,PaO_2也有明显上升;肺系数和BALF中蛋白浓度随EGF剂量的增加呈下降趋势,但低剂量组差异并不显著,中、高剂量组肺系数和蛋白浓度则下降明显;支气管肺泡灌洗液中:三个治疗组与对照组相比细胞总数、巨噬细胞、中性粒细胞、淋巴细胞均明显降低;红细胞、上皮细胞在中、高剂量组中明显降低,低剂量组则下降不明显;增殖上皮细胞的标记指数:治疗组肺上皮细胞标记指数(label index,LI)呈上升趋势,其中高剂量组与对照组和低剂量组相比差异非常显著。
     结论:烟雾吸入性损伤可以导致肺水肿、气道炎性浸润和上皮细胞破坏;外源性EGF可清除肺水肿,抑制气道炎症,促进损伤上皮的增殖和修复,恢复上皮形态和功能的完整性,且随着剂量的增加效果更为明显。
Objective: Through observing the therapeutical effect on smoke inhalation injury on rats with different doses of epidermal growth factor, which are infused in their airways, the doses and the method of epidermal growth factor can be determined and the reference for clinical treatment programmes (dosage, usage) can be provided.
     Methods: The study was divided into two parts: 1. Rat model of smoke inhalation injury: rats were randomly divided into 7 groups——control group and six experiment groups in which rats were killed in 1h, 6h, 12h, 24h, 48h, 72h after inhalation injury. Rats were vulnerated in a special device smoke injuries. To evaluate the effect of smoke inhalation injury model through multiple factors: blood gas analysis, lung index, gross morphometric and pathological obserevation, the count of total number of cells, macrophages, neutrophils, lymphocytes, red blood cells, epithelial cells and protein concentration in bronchoalveolar lavage fluid.
     2. To observe therapeutic efficacy of different doses of epidermal growth factor on rats: Rats were randomly divided into four groups——control group, low dose group(100ug/kg), medium dose group (150ug/kg) and high dose group (200ug/kg), normal sodium and different concentrations of epidermal growth factor(50ug/ml, 75ug/ml, 100ug/ml) 2ml/kg were dropped into airways of rats respectively, BrdU (100mg/kg) was intraperitoneal injected after 12 hours. Rats were killed after 72h and therapeutic efficacy was evaluated through multiple factors: blood gas analysis, lung index, gross morphometric and pathological obserevation , the count of total number of cells, macrophages, neutrophils, lymphocytes, red blood cells, epithelial cells and protein concentration in bronchoalveolar lavage fluid. And we estimated epidermal growth factor on airway epithelial cell proliferation through observing immunohistochemical staining of BrdU.
     Results: 1 .This model of smoke inhalation injury on rats achieves the desire. Blood gas analysis showed that: PH was on a downward trend, and there was significant difference between the groups of 12h, 24h, 48h, 72h after injury and the control group, and PH was the lowest 24h after inhalation injury. PaO_2 decreased significantly while there was significant difference between the groups of 1h,6h,12h, 24h, 48h, 72h after injury and the control group. PaCO_2 was on a upward trend, and there was significant difference between the groups of 24h, 48h, 72h after injury and the control group. There was significant difference between the groups of 12h, 24h, 48h, 72h after injury and the control group in lung index. Lung index reached the peak in 24h after injury, then reduced gradually. Bronchoalveolar lavage fluid: Total number of cells greatly increased after 12h. Macrophage cells, red blood cells significantly increased after 24h.Neutrophils, lymphocytes significantly increased after 6h.Epithelial cells significantly increased at 48h. Protein concentrations in bronchoalveolar lavage fluid of control group was (11.303±5.634)ug/ml, it was on upward trend after injury, [46.956±15.175, P <0.05)] at 48h, [(60.781±35.354, P <0.01)] at 72h, respectively. 2. Saline and different doses of epidermal growth factor were dropped into the airway of rats after injury, and the results demonstrated: PH was on a upward trend with the dose increasing, and there was significant difference between medium dose group, high dose group and control group. PaO_2 was on the upward trend, and PaCO_2 was on a downward trend. There was significant difference between medium dose group, high dose group and control group. PaO_2 of high dose group increased obviously compared with that of low dose group. Lung index and protein concentrations in bronchoalveolar lavage fluid were on downward trend with the doses of epidermal growth factor increased. There was a significant difference between medium dose group, high dose group and control group, but low dose group had no significant differences. Bronchoalveolar lavage fluid: the total number of cells, macrophages, neutrophils, lymphocytes of three treatment groups significantly decreased compared with the control group. Red blood cells and epithelial cells of medium dose group and high dose group significantly decreased compared with the control group. Labeling index of three treatment groups was on the upward trend, high dose group significantly increased compared with the control group and low dose group.
     Conclusion: smoke inhalation injury can lead to pulmonary edema, airway inflammatory infiltration and cell damage. Exogenous epidermal growth factor can remove pulmonary edema, inhibit airway inflammation, promote the proliferation and repair of epithelial injury, and restore the form and function of epithelial integrity. With the increase of doses ,the effects are more obvious.
引文
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