肿瘤坏死因子-α在滑石粉和硝酸银胸膜固定术中的作用

Effect of TNF-α in Experimental Study of Pleurodesis Induced by Silver Nitrate or Talc

目的 :探讨TNF α在胸膜固定术中的作用及大鼠产生胸膜固定术的机制。方法 :健康成年雄性Sprague Dawley大鼠 5 4只 ,6只胸腔内给予Buffer液作细胞因子含量检测对照组 ,余下的随机分为两组 :滑石粉组 (T组 )和硝酸银组 (A组 ) ,在造成大鼠气胸模型后 ,A组注入硝酸银 (0 .1%硝酸银 1ml) ,T组注入 2 0 0mg·kg-1滑石粉 +1.0ml 0 .9%生理盐水。A组和T组分别在注射药物后第 1d、4d、7d、2周时 ,进行剖胸探查收集标本 ,观察大鼠胸膜粘连积分、2 4h胸液量、ELISA法检测 2 4h收集的血清和胸液中TNF α的含量 ,以及各观察时点血清中TNF α的含量 ;过氧化氢法检测肺组织中胶原含量。结果 :滑石粉浆组产生胸膜粘连在初期较硝酸银组快 ,但从第 2周开始 ,硝酸银组产生胸膜粘连效果好于滑石粉浆组 ;2 4h胸液量则硝酸银组多于滑石粉浆组 ;血清中各观察时点TNF α的含量均为滑石粉浆组高于硝酸银组 ,但两组 2 4h胸液中TNF α的含量均高于血清中的含量 ,且在硝酸银组中显著增高。肺组织中胶原含量与血清中TNF α的含量呈正相关。结论 :TNF α是炎症前细胞因子 ,在滑石粉浆和硝酸银所致的胸膜粘连中起关联作用。

Objective: To study the role of TNF-α in the mechanisms of experimental pleurodesis in rats induced by silver nitrate or talc. Methods: Adult Sprague-Dawley rats were randomized divided into three experimental groups: 6 rats were given Buffer. The rest rats were divided into two groups. Group A received 1 ml of 0.1% silver nitrate, while group T received 200 mg·kg -1 of talc slurry in 1 ml intrapleurally. Six rats in each group were killed on day 1, 4,7,14 and 28 after intrapleural injection. Pleural fluid at the first 24 hour, the degree of gross pleurodesi and lung collagen was determined by peroxide method; TNF-α in plasma and 24 h pleural fluid were determined by ELISA. Results: The gross pleurodesis score in the rats that were treated with silver nitrate was 2.0±0.3, which was significantly higher than the score of 1.4±0.1 in the rats that were treated with talc. The mean gross pleurodesis score was significantly higher at almost each of the observation times(P<0.05), except at the first seven days, in the rats that received silver nitrate. The volume of pleural fluid at 24 h following silver nitrate administration were significant higher than that of talc, while the TNF-α in plasma were on the contrary. The TNF-αin 24 h plasma were significant lower in 24 h pleural fluid at the same experimental group. The TNF-α in plasma was positively correlated with the lung collagen. Conclusion: TNF-α is important in the process of pleurodesis.