银杏达莫联合甲基强的松龙对机械通气所致肺损伤大鼠肺组织蛋白酶激活受体-2的表达及肺组织病理结构改变的影响

Influence of yinxingdamo combined with methylprednisolone on the expression of PAR-2 and pulmonary pathological structure of VILI rats

目的观察银杏达莫联合甲基强的松龙对机械通气所致肺损伤(VILI)大鼠肺组织蛋白酶激活受体-2(PAR-2)表达及其对肺组织病理结构的影响,为其在肺损伤过程中的临床应用提供理论依据。方法取112只健康雄性SD大鼠,随机分为四大组各28只,对照组(A组)、机械通气肺损伤组(H组)、机械通气肺损伤+甲基强的松龙组(D组),机械通气肺损伤+甲基强的松龙+银杏达莫组(F组)。机械通气组中每只大鼠采用经环甲膜切开气管插管。各组于机械通气开始时从尾静脉注入等量生理盐水。各组又分为0.5h、1h、2h、3h分为4个亚组,在各时间点用窒息法将大鼠处死,取肺组织在光镜下观察病理改变,PCR法检测PAR-2mRNA的表达,免疫组化检测肺组织PAR-2蛋白的表达,并以SPSS 17.0统计软件分析结果。结果 A组和H组相比,H组大鼠的肺组织损伤评分、PAR-2蛋白表达明显升高(P<0.01);与H组相比,D、F组大鼠肺组织损伤评分、PAR-2蛋白的表达明显降低(P<0.05),以F组降低为甚,差异具有统计学意义。结论机械通气所致肺损伤过程中PAR-2的表达明显升高,银杏达莫及甲基强的松龙可能通过抑制炎性反应及PAR-2的表达而在机械通气所致肺损伤过程中起保护作用。

Objective To observe the effect of yinxingdamo and methylprednisolone on the expres- sion of PAR-2 and pulmonary pathological structure of VILI rats, provide the theorical evidence for their clinical application during the course of lung injury. Methods A total of 112 healthy male Spra- gue-Dawley rats were randomly divided into compared group （A group）, VILI group （H group）, methylprednisolone group （D group）, yinxingdamo ＋ methylprednisolone group, （F group）. Rats were inserted tracheal catheter via cricothyroid membrane under urethane injection anesthesia. Rats in groups were randomly divided into 4 subgroups respectively by 0.5, 1, 2 and 3 h, received same dose of normal saline at the beginning of mechanical ventilation, put the rats to death with smothering method at each time point, pathological changes of pulmonary were observed under light microscope, the mRNA and protein expression of PAR-2 in lungs were detected by RT-PCR and immunohisto- chemistry at each time point, analyze the results with the statistic software SPSS17.0. Results Com- pared with group H, points of lung tissue damage and the expression of PAR-2 mRNA and protein in group H were significantly higher than in group A （P〈0.01）, points of lung tissue damage and the expression of PAR-2 mRNA and protein in group D and F were significantly lower than in group H, decreased more in group F, And there were statistical significantly differences. Conclusion During the course of ventilation induced lung injury, the expression of PAR-2 mRNA and protein increased signif- icantly, yinxingdamo and methylprednisolone could protect mechanical ventilation induced lung injury through inhibiting inflammatory reaction and the expression of PAR-2.