外源性硫化氢对大鼠肢体爆炸伤后继发性肺损伤的作用

Effects of exogenous hydrogen sulfide on secondary lung damage after explosive injury of limbs in rats

目的观察外源性硫化氢(H2S)对大鼠肢体爆炸伤后继发性肺损伤的作用,探讨H2S在肢体爆炸伤后继发性肺损伤防治中的临床应用价值。方法采用大鼠肢体爆炸伤模型,动物随机分为3组(n=8/组):正常对照组(Ⅰ)、单纯致伤组(Ⅱ)和致伤+外源性H2S组(Ⅲ);伤后6小时取标本。测定血浆和肺组织肿瘤坏死因子-α(TNF-α)、白介素-6(IL-6)、白介素-10(IL-10)浓度,肺组织髓过氧化物酶(MPO)活性和丙二醛(MDA)浓度;观察肺脏病理学变化。结果致伤后6小时大鼠血浆和肺组织TNF-α、IL-6、IL-10浓度和肺组织MDA浓度及MPO活性显著升高(P<0.01,vsⅠ),肺充血、水肿和炎细胞浸润明显;给予硫氢化钠(NaHS)处理后伤鼠血浆和肺组织TNF-α、IL-6、IL-10和肺组织MDA浓度及MPO活性显著降低(P<0.05,vsⅡ),肺充血、水肿和炎细胞浸润程度较单纯致伤鼠明显减轻。结论肢体爆炸伤可引起大鼠严重的继发性肺损伤;而早期给予外源性H2S可明显抑制肺脏炎性损伤和氧化损伤,减轻肺充血、水肿和炎细胞浸润程度,从而减轻继发性肺损伤。

Objective To observe the effects of exogenous hydrogen sulfide（ H2S） on secondary lung damage after explosive injury of limbs in rats, and explore the clinical value for exogenous H2S in the fields of the therapy for explosive injury. Methods Explosive injury of limbs was adopted. Healthy male Sprague-Dawley rats （210 - 220g） were randomly divided into three groups （n =8/per group） as follow： normal control group（Ⅰ ） ,simple explosive injury group （ Ⅱ ）, explosive injury ＋ NailS group （ Ⅲ ： 4mg/ml NailS, 10mg/kg, ip, immediately ）. Lung samples were collected 6h after explosion. TNF-α,IL-6, IL-10 concentration in plasma and lung were determined; MPO activity and MDA concentration in lung were determined. The pathological changes of lung were observed. Results Six hours after explosive injury, TNF-α, IL-6, IL-10 concentrations in plasma and lung, MPO activity and MDA concentration in lung remarkablely increased （ P 〈 0.05, vs Ⅰ ） and showed severe pneumonemia, pneumonedema and inflammatory cell infiltration. But after administration of NailS, these indexes decreased significantly （ P 〈 0.05, vs Ⅱ ） , pneumonemia, pneumonedema and inflammatory cell infiltration were relieved significantly. Conclusion Explosive injury of limbs could induce severe secondary lung damage; and administration of exogenous hydrogen sulfide could relieve secondary lung damage after explosive injury of limbs.