液体复苏联合氢气吸入对脓毒性休克大鼠肺脏的作用

Effects of early liquid resuscitation combined with hydrogen inhalation on lung injury in septic shock rats induced by lipopolysaccharides

目的:研究早期液体复苏联合氢气吸入对脓毒性休克大鼠肺脏凋亡蛋白和炎症介质表达的影响。方法:60只Wistar大鼠随机分成4组:正常对照组(A组)、休克对照组(B组)、液体复苏组(C组)和液体复苏联合氢气吸入组(D组),每组15只大鼠。所有大鼠给予经口气管插管机械通气,呼吸机模式及参数相同。LPS静脉注射建立脓毒性休克模型,A、B和C组吸入气体为空气,D组吸入气体为2%氢空混合气。C和D组给予相同的液体复苏方案。2 h后处死大鼠,HE染色观察肺组织形态学变化,ELISA检测支气管肺泡灌洗液(BALF)中炎症介质的表达,免疫组化和Westen blotting检测肺组织中Fas及Bcl-2的表达。结果:D组与C组比较,BALF中促炎介质水平明显降低(P<0.05),Fas表达明显减弱(P<0.05),Bcl-2表达明显增强(P<0.01)。结论:联合氢气吸入的液体复苏方案与单纯液体复苏比较,可通过降低炎症介质水平及减少肺脏细胞凋亡而保护肺功能。

AIM： To study the effects of fluid resuscitation combined with 2% hydrogen inhalation on lung in- jury in septic shock rats induced by lipopolysaccharides （LPS）. METHODS： Sixty male Wistar rats were randomized to 4 groups ： normal control group, septic shock control group, fluid resuscitation group and fluid resuscitation plus hydrogen in- halation group. Liquid resuscitation was applied to the rats in fluid resuscitation group and fluid resuscitation plus hydrogen inhalation group. The rats in fluid resuscitation plus hydrogen inhalation group also received 2% hydrogen inhalation and the rats in other groups inhaled air for control. The pathological changes of the lung were observed under light microscope. The levels of inflammatory mediators in bronchoalveolar lavage fluid （BALF） were measured by ELISA. The expression of Fas and Bcl-2 was detected by Western blotting. RESULTS ： Compared with fluid resuscitation group, the levels of inflam- matory mediators in BALF and the expression of Fas in lung tissues were decreased, and the expression of Bcl-2 in lung tis- sue was increased in fluid resuscitation plus hydrogen inhalation group. CONCLUSION： Fluid resuscitation with 2% hy- drogen inhalation exhibits a protective effect on lung injury induced by LPS.