肺表面活性蛋白-D在高原肺水肿发生发展中的表达及作用

Expression and effect of pulmonary surfactant protein-D in the occurrence and development of high altitude pulmonary edema

目的探讨肺表面活性蛋白-D(SP-D)在高原肺水肿发生发展中的表达及作用。方法将64只Wistar雄性大鼠随机分为4组,正常对照组(16只,586 m室温饲养),低压低氧24 h、48 h及72 h组(各16只,于模拟海拔6000 m低压低氧舱内分别饲养24 h、48 h及72 h),取右侧肺组织行HE染色,观察肺组织损伤情况,收集左侧肺组织肺泡灌洗液,采用酶联免疫吸附法(ELISA)测定支气管肺泡灌洗液(BALF)中SP-D、白介素(IL)-1β、IL-6、C反应蛋白(CRP)及肿瘤坏死因子α(TNF-α)的含量。结果成功建造高原肺水肿动物模型;与正常对照组相比,低压低氧24、48、72 h组肺组织病理评分升高,差异有统计学意义(P<0.05);SP-D含量均有所下降,IL-1β、IL-6、CRP、TNF-α含量均上升,且各组间两两比较差异均有统计学意义(P<0.05);BALF中SP-D含量与肺组织病理评分呈负相关(r=-0.687,P<0.05),炎症因子IL-1β、IL-6、CRP及TNF-α与肺组织病理评分均呈正相关(r=0.705,P<0.05;r=0.728,P<0.05;r=0.733,P<0.05;r=0.737,P<0.05)。结论SP-D在高原肺水肿的发生发展中起着一定的作用,其可能是防治高原肺水肿的新靶点。

Objective To investigate the expression and effect of pulmonary surfactant protein-D(SP-D)in the occurrence and development of high altitude pulmonary edema.Methods 64 male Wistar rats were randomly divided into four groups:normal control group(n=16,586 m altitude with room temperature feeding),low-pressure hypoxia 24 h,48 h and 72 h group(n=16,feeding in a simulated altitude 6000 m with low-pressure hypoxia chamber for 24 h,48 h and 72 h,respectively).The right lung tissue was used for HE staining to observe the lung tissue injury.The alveolar lavage fluid of the left lung was taken to measure the SP-D,IL-1β,IL-6,CRP and TNF-αby enzyme-linked immunosorbent assay.Results The animal model of high-altitude pulmonary edema was successfully established.Compared with the control group,the pathological scores of lung tissue in the 24,48 and 72 h hypoxia groups were increased.The protein expression of SP-D was decreased while IL-1β,IL-6,CRP and TNF-αwere increased significantly(P<0.05).SP-D in alveolar lavage fluid was negatively correlated with lung histopathological score(r=-0.687,P<0.05).Inflammatory factors IL-1β,IL-6,CRP and TNF-were positively correlated with lung histopathological score(r=0.705,P<0.05;r=0.728,P<0.05;r=0.733,P<0.05;r=0.737,P<0.05).Conclusion SP-D plays a important role in the occurrence and development of high altitude pulmonary edema,which may be a new target for the prevention and treatment.