严重肺挫伤及缺血再灌注早期TNF-α动态与肺泡II型细胞形态学关系

Relationship between dynamic changes in TNF-α and morphology of type II alveolar cells in severe lung contusion and early ischemia-reperfusion injury

目的探讨严重肺挫伤及缺血再灌注后早期肺泡灌洗液中(BALF)及血清中TNF-α动态与肺形态学的关系。方法75只实验兔随机分为对照组A(n=25)、实验组B(LC,n=25)及C(LIRI,n=25);检测各组0,1,2,3,4h肺功能变化及BAlF中SP-A、B、C、D含量百分比,组织病理及电镜检查。结果B、C组1h血清及BALF中TNF-α浓度开始上升,2～3h间达到顶峰,3～4h间又急剧下降;而对照组血清及BALF中TNF-α浓度无明显变化。B、C组1～4h肺泡II型细胞电镜及病理检查呈不同程度的炎症及变性改变且持续加重。结论严重肺挫伤及缺血再灌注后1～3hBALF及血清中TNF-α持续升高,与肺泡II型细胞病理改变相一致。

Objective To study the relationship between dynamic changes in TNF -α and morphology of type Ⅱ alveolar cells in severe lung contusion and early ischemia - reperfusion injury in rabbits. Methods Seventy - five cases rabbits were randomly divided into three groups （ group A： controls; group B ： lung contusion and group C ： lung contusion combined ischemia - reperfusion injury）. TNF -α level in BALF and serum and the change of morphology of alveolar cells were examined after lung contusion and ischemia - reperfusion injury. Results TNF -α concentration in serum and BALF rapidly increased in point 2 - 3, but decreased in point 4. In group B and group C, the damage of type Ⅱ alveolar epithelial cells （AECⅡ） was observed in lung tissue in point 1 to 4. Results TNF-αconcentration in serum and BALF rapidly increased in point 2 - 3, but decreased in point 4. In group B and group C, the damage of type II alveolar epithelial cells （AECII） was observed in lung tissue in point 1 to 4. Conclusion The change coincide with the rising of TNF-α in the serum and BALF increases 1 ～3 hours following lung contusion and ischemia - repeffusion injury, in accordance with morphology changes in type II alveolar cells.