家兔侧脑室注射组胺受体拮抗剂对神经源性肺水肿的影响

Role of central histamine injected intracerebroventricularly in etiological mechanism of neurogenic pulmonary edema in rabbits

目的:探讨内源性组胺在家兔神经源性肺水肿(NPE)发生中的作用。方法:在家兔侧脑室微量注射H1受体拮抗剂扑尔敏和H2 受体拮抗剂西米替丁,采用形态、功能、生化指标相结合的方法,探讨中枢组胺与NPE发生之间的关系。测定指标包括下丘脑后区(PHA)、延髓头端腹外侧区(RVLM)组胺含量、血浆一氧化氮(NO)含量、肺水比及水肿液蛋白/血浆蛋白(A/P)值,光镜观察肺组织病理切片。结果:(1)NPE家兔PHA及RVLM组胺含量明显增高(P <0 .0 0 1) ;(2 )注射扑尔敏后肺水比和A/P值显著降低(P <0 .0 1) ;(3 )注射扑尔敏后血浆NO含量明显降低(P <0 .0 5 )。结论:肺毛细血管通透性的改变存在于NPE病理生理过程中;组胺通过中枢H1受体介导参与NPE的发病过程;血浆NO参与中枢组胺调控NPE的肺损伤过程。

Objective To explore the role of central histamine in the onset of neurogenic pulmonary edema (NPE). Methods Chlorphenamine maleate and cimetidine were injected intracerebroventricularly to examine its morphologic, functional and biochemical changes in NPE rabbits. Results Brain histamine of posterior hypothalamic area (PHA) and rostral ventrolatral medullar (RVLM) in NPE rabbits were significantly increased. Injection of chorphenamine dramaticly decreased the ratia of lungwater,the content of NO and A/P value, increased the PP. However,citetidine produced no change. Conclusion Central histamine,mediated by H_1 receptor, take part in the onset of NPE. Pulmonary capillaries increase their permeabilities in the process of NPE and NO is involved in pulmonary damage.