小潮气量高频机械通气对糖尿病模型小鼠肺损伤和炎症因子的影响

The Protective Mechanical Ventilation Strategy Based on Low Tidal Volumes and High Frequency Increases Lung Injury in Diabetes Mice

目的观察小潮气量高频机械通气对糖尿病模型小鼠肺损伤和炎症因子的影响。方法成年雄性C57BL/6N小鼠40只,采用随机数字表法分为糖尿病+机械通气组(Dia-MV)、糖尿病+自主呼吸组(Dia-SB)、正常对照+机械通气组(Con-MV)和正常对照+自主呼吸组(Con-SB组),各10只。检测各组小鼠血浆肿瘤坏死因子(TNF-α)、白细胞介素-6(IL-6)、白细胞介素-10(IL-10)、超氧化物歧化酶(SOD)和丙二醛(MDA)含量。RT-PCR法检测各组小鼠肺组织匀浆TNF-α、IL-6和IL-10表达量。改良组织学评分系统评估肺损伤程度。结果与治疗前相比,Dia-MV组血浆TNF-α、IL-6和IL-10水平随通气持续时间逐渐增加,而Con-SB组无显著变化。肺匀浆上述促炎细胞因子定量RT-PCR分析与血浆结果类似。Dia-MV组血浆SOD活性随着机械通气进行降低,MDA水平增加。肺匀浆SOD/MDA定量RT-PCR分析与血浆结果类似。与Con-SB组[(0.64±0.05)分]相比,Dia-MV组[(3.83±0.34)分,P<0.05)]、Dia-SB组[(2.11±0.20)分,P<0.05]、Con-MV[(1.98±0.18)分,P<0.05]肺损伤评分增加。结论小潮气量高频机械通气增加糖尿病模型小鼠肺损伤。

Objective To investigate the effects of protective mechanical ventilation（MV） strategyon inflammation and lung injury in mice withdiabetes. Methods Forty C57BL/6N mice were randomly divided two groups： diabetic model was established in 20 mice and then subdivided into MVgroup（Dia＋MV group） and spontaneous respiratory（SB） group（Dia＋SB group）, with 10 mice in each; another 20 normal mice served as controls, which were also subdivided into Con＋MV group and Con-SB group, with 10 mice in each. Tumor necrosis factor-α（TNF-α）, interleukin-6（IL-6）, interleukin-10（IL-10）, superoxide dismutase（SOD） and malondialdehyde（MDA） levels in serum were detected and the expression of inflammatory cytokine m RNA was also determined in lung tissue.Lung damage was assessed using a modified lung injury score. Results Compared to baseline values, the serum levels of TNF-α,IL-6 and IL-10 were gradually increased over ventilation duration in Dia-MV group, while no similar results were observed in con-SB group. The activities of serum SOD decreased and MDA levels were conversely increased along with ventilation duration in Dia-MV group. Quantitative RT-PCR analysis of pro-inflammatory cytokines in lung homogenates presented similar results.The modified lung injury score was higher in Dia-MV group, Dia-SB group and Con-MV group as compared to that in Con-SB group（3.83±0.34, 2.11±0.20, 2.11±0.20 vs 0.64±0.05, P〈0.05）. Conclusion The protectivemechanical ventilation strategy based on low tidal volumes and high frequency increased the inflammation reaction and associated lung injury in diabetic mice.