调控腹膜淋巴孔在大鼠腹腔感染早期对内毒素肺损伤的影响

Effect of regulation of peritoneal lymphatic stomata on endotoxin induced lung injury in rats with early abdominal infection

目的:探讨腹腔感染早期,调控腹膜淋巴孔对内毒素肺损伤的影响.方法:将54只Wister大鼠随机分为3组:对照组(n=18),开腹后翻动盲肠注射生理盐水;试验组(n=18),开腹后行盲肠结扎穿孔手术(cecum ligation perforation,CLP);干预组(n=18),CLP手术术前1.0 h及术后(0.5、2.0 h)腹腔注射氯沙坦钾溶液.检测3组大鼠腹膜淋巴孔孔径大小和分布密度、淋巴浆内毒素浓度,肺组织核因子-κB(nuclear factorκB,NF-κB)P65免疫组织化学平均光密度值、Caspase3酶相对活性.结果:(1)试验组随时间延长,腹膜淋巴孔孔径、分布密度及淋巴浆内毒素浓度逐渐增加(P<0.05);干预组淋巴孔和内毒素指标:术后2.0 h高于术后0.5 h(P<0.05)、术后高于术前(P<0.05);(2)干预组肺组织NF-κB P65及Caspase3的水平:术前低于术后(P<0.05),术后2.0 h高于术后0.5 h(P<0.05).结论:(1)腹腔感染早期,血管紧张素Ⅱ受体抑制剂可以调控腹膜淋巴孔,减轻内毒素导致的肺损伤;(2)干预时间越早,肺损伤程度越轻.

AIM：To investigate the effect of regulation of peritoneal lymphatic stomata on endotoxin induced lung injury in early abdominal infection.METHODS：Fifty-four Wister rats were randomly divided into three groups：a control group（n =18） to receive sham operation and intraperitoneal injection of saline solution,an experimental group（n = 18） to receive intraperitoneal ligation perforation（CLP） and cecum injection of saline solution,and an intervention group（n = 18）to receive CLP and intraperitoneal injection of losartan potassium 1.0 h before and 0.5 and 2.0h after surgery.The aperture size and density of peritoneal lymphatic stomata,lymph endotoxin concentration,immunohistochemical average optical density of nuclear factor kB（NF-kB） P65 in lung tissue,and relative Caspase3 protease activity in lung tissue were measured and compared for the three groups.RESULTS：As time went by,peritoneal lymphatic stomata aperture and density and lymph endotoxin concentration gradually increased in the experimental group（P〈0.05）.In the intervention group,lymphatic stomata and endotoxin indexes were significantly higher after operation than before operation,and at 2.0 h after operation than at 0.5 h（P〈0.05）.NF-kB P65 expression and Caspase3 activity in lung tissue were also significantly higher after operation than before operation,and at 2.0 h after operation than at 0.5 h（P〈0.05）.CONCLUSION：In early abdominal infection,angiotensin Ⅱ receptor（AngⅡ-R） inhibitor can regulate the peritoneal lymphatic stomata and reduce lung injury caused by endotoxin.Earlier intervention is associated with milder lung injury.