功能性肺叶切除中不同药物致靶肺纤维化作用的差异

Target-pulmonary fibrosis induced by virous durgs in functional pulmonary lobectomy

目的比较平阳霉素、碘化油、平阳霉素-碘化油乳剂三组药物致靶肺纤维化作用的差异。方法24只健康家兔随机分成三组,每组8只,分别采用平阳霉素、碘化油、平阳霉素-碘化油乳剂灌注右下肺叶,以骨水泥封堵支气管开口并摄胸片。在第30天切取靶肺,行HE染色、测定HYP含量,另用Western-blot法检测MMP-2、MMP-9表达蛋白量,分析组间差异。结果胸片上碘化油组呈支气管树表现,平阳霉素-碘化油乳剂组整个右下肺叶被充填,灌注试剂分布均匀。光镜下碘化油组见炎性渗出,有少量胶原纤维沉积,平阳霉素组、平阳霉素-碘化油乳剂组肺泡萎陷,弥漫性纤维组织增生。平阳霉素组与平阳霉素-碘化油乳剂组HYP含量及MMP-2、MMP-9表达蛋白量差异无统计学意义(P>0.05),而与碘化油组之间差异均有统计学意义(P<0.05)。结论平阳霉素-碘化油乳剂具有相对较高的安全性和较强的致肺纤维化作用,是FPLT较理想的灌注药剂。

Objective To compare the effect of Pingyangmycin-iodine oil emulsion, Iodine oil and Pingyangmycin as filling agent for target lung in the procedure of functional pulmonary lobectomy （FPLT）. Methods Twenty-four healthy rabbits were divided into three groups randomly （each n = 8）： pingyangmycin group （group A）, Iodine oil group （group B） and Pingyangmycin-iodine group （group C）, and the low right lobe of lung were filled respectively under fluorpscopy. Then the target bronchi were occluded with polymethylmethacrylate （PMMA）. After operation, rabbits in each group were killed on 30th day and target lungs were harvested. Some acquiring samples were routinely HE stained for assessing the general histological appearance of lung tissue; others were used to measure hydroxyproline （HYP） content. In addition, the expressions of MMP-2 and MMP-9 were observed with Western-blot. Results The Iodine oil diffused evenly in district of target lobes in group C, while that of group B could only be seen in main bronch-branch and part of pulmonary alveolus. Histologically, there were many small abscesses in group C and less collagen fibers deposited in the interstitial tissue of lung in compare with the other two groups. Compared with group B, the content of hydroxyproline （HYP） and the expressions of MMP-2 and MMP-9 were significantly higher in group A and group C. Conclusion Pingyangmycin-iodine oil emulsion is the best filling agent in functional pulmonary lobectomy.