西维来司钠对家兔早期肺爆震伤的治疗作用

Therapeutic effect of sivelestat sodium on early lung blast injury in rabbits

目的 探讨家兔早期肺爆震伤中中性粒弹性蛋白酶（NE）的变化及西维来司钠的治疗作用.方法 将30只健康新西兰大白兔随机分为：A组（对照组）和B组治疗组（西维来司钠）.治疗组伤后立即给予西维来司钠10 mg/kg耳缘静脉注射;对照组经耳缘静脉注射同等剂量的生理盐水.检测治疗前及伤后血浆中肿瘤坏死因子（TNF）-α含量及NE活性.结果 西维来司钠治疗组治疗后氧分压（PO2）在1、6、12h3个时间点分别为（89.1±9.7）、（90.9±10.5）、（101.1±7.0） mmHg（1 mmHg =0.133 kPa）,较对照组的（81.3±8.7）、（74.2±7.8）、（94.2±9.8）mmHg明显升高（P＜0.05）,TNF-α含量在1、6、12h3个时间点治疗组分别为（122.8 ±13.6）、（85.1±12.9）、（81.1±7.2）ng/L,较对照组的（151.4 ±12.1）、（101.3±10.8）、（93.8±10.5）ng/L明显下降（P＜0.05）、NE活性在1、6、12、24 h各时间点治疗组分别为（70.5 ±6.1）、（104.8±5.4）、（84.5±4.6）、（56.3±8.6）ng/L,较对照组的（91.8±6.3）、（160.5±9.5）、（127.7±8.3）、（109.4±7.2） ng/L均明显下降（P＜0.05）.结论 NE活性在肺爆震伤病情发生、发展中起到重要作用.西维来司钠治疗肺爆震伤后早期可以明显抑制血浆NE活性及炎性细胞因子TNF-α的释放,减轻中性粒细胞浸润.

Objective To investigate the changes of neutrophil elastase （NE） and the therapeutic effects of sivelestat sodium on early blast lung injury in rabbits.Methods 30 healthy New Zealand rabbits were randomly divided into：group A was the control group;B group was the treatment group （sivelestat sodium）.Given the sivelestat sodium 10mg/kg through ear vein injection immediately after injury to treatment group;saline control group,intravenous injection of the same dose.Tumor necrosis factor-α （TNF-α） content and NE activity in plasma were measured before treatment and after injury.Results PO2 of Sivelestat treated group were （89.1 ±9.7）,（90.9 ±10.5）,（101.1 ±7.0） mmHg （1 mmHg =0.133 kPa）that was significantly higher than the control group [（81.3 ±8.7）,（74.2 ±7.8）,（94.2 ±9.8） mmHg]at 1,6,12 three time points （P 〈0.05）,TNF-α content of the treated group （122.8 ± 13.6）,（85.1 ± 12.9）,（81.1 ± 7.2） ng/L decreased significantly compared with the control group （151.4 ± 12.1）,（101.3 ± 10.8）,（93.8 ± 10.5） ng/L at 1,6,12 three time points （P 〈0.05）,NE activity of the treated group （70.5 ±6.1）,（104.8 ±5.4）,（84.5 ±4.6）,（56.3 ±8.6） ng/L decreased significantly compared with the control group （91.8 ±6.3）,（160.5 ±9.5）,（127.7 ±8.3）,（109.4 ±7.2） ng/L at all 1,6,12,24 four time points （P 〈 0.05）.Conclusion NE activity played an important role in the occurrence and development.Sivelestat sodium can inhibit the activity of plasma NE and inflammatory cytokine release of TNF-α,reduce the infiltration of neutrophils after early blast lung injury.