西维来司钠对脑损伤继发吸入性肺损伤大鼠的影响研究

The effects of sivelestat sodium on secondary lung injury by aspiration in severe brain injury rats

目的:探讨西维来司钠(Sivelestat sodiom)雾化吸入对脑损伤继发肺损伤大鼠的影响,从炎性反应角度探讨其作用机制。方法:SD大鼠60只,随机分为6组,正常组(A),误吸组(B),脑损伤误吸组(C),生理盐水雾化吸入组(D),地塞米松雾化吸入组(E),西维来司钠雾化吸入组(F),每组10只,用酶联免疫吸附(Enzyme-linked immunosorbent assay,ELISA)法测定支气管肺泡灌洗液(Bronchoalveolar lavage fluid,BALF)的中性粒细胞弹性蛋白酶(Neutrophil elastase,NE)和白介素-8(Interleukin-8,IL-8)含量,免疫透射比浊法测定BALF中白蛋白浓度;光镜观察肺组织病理改变。结果:F组肺组织形态学改善最明显,其次为E组;E、F组大鼠BALF中NE低于B、C、D组(P<0.05),F组最明显;E、F组大鼠BALF中IL-8含量均低于C、D组(P<0.05),但E、F 2组间差异无统计学意义(P>0.05)。结论:西维来司钠雾化吸入对脑损伤继发吸入性肺损伤大鼠肺组织的改善作用优于地塞米松,其作用机制可能与抑制NE的产生和活性,减轻NE对肺组织的直接损伤作用和抑制肺内炎性网络循环反应导致的肺组织损伤有关。

Objective：To study the effects of sivelestat sodium atomization inhalation on secondary lung injury by aspiration in severe brain injury rats and to explore its mechanism from the perspective of inflammatory reaction.Methods：60 SD rats were randomly divided into six groups：normal group（A）,aspiration group（B）,aspiration of brain injury group（C）,saline control group（D）,dexamethasone atomization inhalation group（E）,and sivelestat sodium atomization inhalation group（F）,10 rats in each group.Neutrophil elastase（NE） and interleukin-8（IL-8） content in bronchoalveolar lavage fluid（BALF） were detected by using enzyme-linked immunosorbent assay（ELISA）.Immune turbidimetry was used to determine the albumin concentration in the BALF.Pathological changes in lung tissue were observed by optical microscope.Results：The changes of Morphological characteristic of the lung tissue in F group were improved most significantly,the following was E group.The contents of NE in the BALF in group E and F were lower than that in group B,C and D（P〈 0.05）,and The contents of NE in group F were reduced most obviously in all groups.The contents of IL-8 in the BAlF between group E and F showed no significant difference（P〉0.05）,which were lower than those in group C and D（P〈 0.05）.Conclusion：Sivelestat sodium and dexamethasone atomization inhalation have a positive effect on the rats of brain injury with secondary inhalation lung injury,but sivelestat sodium is superior to dexamethasone,and its mechanism may be that sivelestat sodium may inhibit the production of NE and its activities and alleviate the direct injury of lung tissue induced by NE and inhibit the lung injury caused by the inflammatory reaction of the lung.