大鼠烟雾吸入性肺损伤后血浆和肺泡灌洗液中肿瘤坏死因子α水平的变化及其意义

Changes of tumor necrosis factor α levels after smoke inhalation injury

目的：探讨肿瘤坏死因子α（ＴＮＦα）在烟雾吸入性肺损伤发生发展中的可能作用。方法：采用大鼠烟雾吸入致伤模型，动态观察伤后血浆及支气管肺泡灌洗液（ＢＡＬＦ）ＴＮＦα含量的变化，辅以动脉血气分析、肺水量测定、ＢＡＬＦ中白细胞分类计数和病理检查。结果：伤后动物出现急性呼吸衰竭和严重肺水肿，肺内大量炎性细胞聚集、浸润；血浆及ＢＡＬＦ中ＴＮＦα水平均明显升高，且与肺水量和ＢＡＬＦ内中性粒细胞数的增加呈显著正相关。结论：ＴＮＦα不仅参与了伤后肺水肿的发生发展，而且在增强局部炎症反应中可能有重要作用。

Objective:To investigate the possible roles of tumor necrosis factor α (TNFα) in the onset and development of acute lung injury caused by smoke inhalation.Methods:Following the use of a rat smoke inhalation injury model,the present study was designed to determine the dynamic changes of TNFα levels in plasma and bronchoalveolar lavage fluid (BALF) after injury.The concomitant changes of arterial blood gas levels,lung water volume,differential count of white blood cells in BALF,and pathomorphology of lung tissues were also observed.Results:Animals showed acute respiratory failure and serious pulmonary edema after smoke inhalation.A lot of inflammatory cells aggregated and infiltrated in the lungs.Both TNFα contents in plasma and BALF increased markedly and TNFα level was found to have a significantly positive correlation with lung water volume and the number of neutrophils in BSALF.Conclusions:TNFα may contribute not only to the development of pulmonary edema but also to the enhancement of the local inflammatory reaction after smoke inhalation injury.