吸入一氧化氮防治放射性间质肺炎疗效观察

lnhaling nitric oxide to prevent and cure radiation interstitial pneumonia

目的 观察吸入一氧化氮对放射性间质性肺炎的防治效果 ,以期探索防治放射性肺炎的新措施。方法 建立放射性肺纤维化动物模型 ,分别在照前 1d(B和C组 )及照后 1个月 (D和E组 )开始吸入NO ,每种方式均持续治疗 1个月 ,NO吸入浓度为 2 0× 10 - 6 (B和D组 )和 10× 10 - 6 (C和E组 )两个剂量 ,单纯照射组 (A组 )和正常对照组 (F组 )不加任何处理。分别于照射后 1d、1周、1个月、3个月和 6个月取材观察。结果 动物死亡率B组 (10 % )和C组 (5 % )低于其他各组 ;照射后1个月 ,肺重与体重之比B组和C组低于A组 (P <0 0 5 ) ;照后 6个月 ,A组呈现局灶性纤维化 ;B和C组主要在肺叶顶部可见局灶性增生和轻度纤维化病变 ;D和E组可见有较大面积的增生灶 ,主要集中在肺叶顶部。结论 照射前吸入NO明显减轻放射性急性间质肺炎的发生及其病变程度 ,降低动物死亡率 ,延缓和减轻肺纤维化发生的时间和程度 。

Objective\ To investigate the effect of inhaling nitric oxide to prevent and cure radiation interstitial pneumonia. Methods\ The whole rat thorax of all rats was irradiated with 30 Gy 60 Co γ rays and a pulmonary fibrosis model was made at month 3 after irradiation.The starting time of inhaling NO was one day before (B and C groups) or one month after (D and E groups) irradiating,respectively,and the duration of inhalation was one month for every group.The concentration of NO inhaled was 20 ppm (B and D groups) and 10 ppm (C and E groups). Group A was not treated with NO.The lung specimens were harvested 1 w,1 m,3 m and 6 m after irradiation. Results\ Mortalities of group B and group C were 10% and 5%,respectively,which were lower than that of group A (22.6%),group C(34.3%) and group D(14%).Acute interstitial pneumonia was observed in each group at 1 month after irradiation.But the inflammatory reaction and tissue damage in group B and C were slighter than other groups.The ratio of lung weight to body weight in group A was higher than that of groups B and C ( P <0 05).At month 6 after irradiation,patches of fibrosis were formed in group A,which was mainly found around bronchi blood vessels and the apex of lung PO 2 was decreased in group A significantly compared with other groups( P <0 05).In groups B and C slight focal hyperplasia and fibrosis were found in the apex of lung.In groups D and E,large areas of proliferation were seen,and mainly in the apex of lung. Conclusion By inhaling NO before irradiation,the radiation interstitial pneumonia can be attenuated, mortality decreased,and fibrosis delayed and reduced.For inhalation of NO after irradiation,the effect will be decreased.