高容量通气对兔肺组织肿瘤坏死因子-α、白介素-1β、转化生长因子-β_1表达的作用

Effect of high tidal ventilation on the expression of tumor necrosis factor-α, interleukin-1β and transforming growth factor-β_1 in rabbits' lung tissue

目的:探讨高容量机械通气对大白兔肺组织TNF-α、IL-1β、TGF-β1的作用。方法:将30只3月龄雄性大白兔随机分成3组:对照组、常规潮气量组及大潮气量组,每组各10只。对照组插管后不机械通气,另2组插管后机械通气。常规潮气量组VT8mL/kg,大潮气量组VT25mL/kg,其它参数相同,通气时间24h。观察实验前后动脉血pH值、PaO2及PaCO2的变化、ELISA法测定肺组织TNF-α、IL-1β,SABC法测定TGF-β1、测定肺组织湿/干重(W/D)值、观察肺组织病理学变化。结果:与对照组比较,大潮气量组通气24h后动脉血pH、PaO2和PaCO2变化显著(均P<0.05),肺组织W/D、TNF-α、IL-1β、TGF-β1升高(均P<0.01),肺组织水肿,常规潮气量组相应指标无显著变化(P>0.05)。结论:大潮气量机械通气易发生呼吸机相关性肺损伤(VILI),表现为动脉氧分压、肺组织W/D、肺组织病理变化,同时肺组织TNF-α、IL-1β、TGF-β1升高,表明VILI与TNF-α、IL-1β、TGF-β炎性细胞因子有关。

Objective ： To explore the effect of high tidal mechanical ventilation on the expression of tumor necrosis factor-a （TNF-a）, interleukin-l13 （IL-1B） and transforming growth factor-131 （TGF-a） in lung tissue of rabbits. Methods： Thirty healthy 3 month old male rabbits were randomly divided into control group, conventional tidal volume group and high tidal volume group （ l0 rabbits in each group）. Rabbits in control group were not given mechanical ven- tilation after intubation, while the other 2 groups were given mechanical ventilation after intubation. Conventional tidal volume group （C-VT） ：VT： 8mL/kg, high tidal volume group （H-VT） ： VT： 25mL/kg, both for 24 hours, and with same other parameters. Changes of arterial blood pH, PaO2 and PaCO2 were observed before and after experiment. Lev- els of TNF-ct and IL-113 in the lung tissue were detected by ELISA, and TGF-131 was detected by SABC. The wet and dry weight （W/D） ratio of lung tissue were calculated, and pathological changes of the lung tissue were observed. Re- sults： Compared with those of control groups, arterial blood pH, PaO2 and PaCO2 changed significantly in high tidal volume group （P 〈0.05） , the lung tissue levels of W/D, TNF-a, IL-1B and TGF-B1 increased also in high tidal vol- ume group （P 〈 0.01 ）. There was no significant changes in lung tissue edema and corresponding indicators in conven- tional tidal volume group（ P 〉 0.05 ）. Conclusions： High tidal volume ventilator are prone to develop ventilator induced lung injury （VILI） , manifested as the change of arterial oxygen pressure, lung tissue W/D, pathological changes of lung tissue, at the same time, TNF-（x,IL-1 i3 and TGF-B1 were increased. TNF-a,IL-a and TGF-B1 may play an im- portant role in the occurrence and development of VILI.