产前服用维生素A及地塞米松对膈疝胎鼠肺结构的影响

目的:探讨产前应用维生素A及地塞米松对先天性隔疝胎鼠肺结构的影响比较。方法:将24只成年健康SD雌鼠定时配种成功后分为4组,对照组,CDH组,Dex+CDH组及VitA+CDH组,以除草醚诱导建立大鼠CDH动物模型,并将肺组织进行HE染色和图像分析。结果:CDH组中肺重/体重(Lw/Bw)小于对照组,其差异有统计学意义(P<0.01)。Dex+CDH和VitA+CDH组均与CDH组相比有统计学差异(P<0.01)。CDH组胎肺的轴向腺泡计数(RAC)和肺泡面积比例(Alveoli%)均小于正常对照组,其差异有统计学意义(P<0.01);而Dex+CDH和VitA+CDH组与膈疝组相比有统计学差异(P<0.01)。在外径ED无统计学差异的条件下,膈疝组胎肺的IAPA(肺腺泡内动脉)的MT%(中膜厚度)大于正常对照组,其差异有统计学意义(P<0.01);而Dex+CDH和VitA+CDH组中的IA-PA的MT%小于CDH组,其差异有统计学意义(P<0.01)。结论:维生素A是一种替代地塞米松用于先天性膈疝的产前治疗的潜在药物,可避免临床应用地塞米松干预可能产生的副作用。

The Effect of Vitamin A and Dexamethasone Administration on Fetal Lung Architecture on Nitrofen-induced Rat Model of Congenital Diaphragmatic Hernia

Objective: To explore the effect of vitamin A and dexamethasone on the fetal lung nitrofen-induced congenital diaphragmatic hernia(CDH) rat model.Methods: Time-mated Sprague-Dawley female rats were exposed to either control or a single oral dose(100mg/kg) of nitrofen on Gd 8.5(gravida day).Four groups of pregnant rats were designed on Gd 17.5: control(exposed neither to nitrofen nor vitamin A)(n = 6),CDH(exposed to nitrofen with CDH)(n = 6),Dex+CDH(n = 6),Vit A+ CDH(n = 6).All fetuses were delivered by cesarean section on Gd 21.5.Accordingly,there were four groups of fetuses: Control(n = 42),CDH(n = 26),Dex+CDH(n = 22),Vit A + CDH(n = 24).Fetal lung histologic evaluations were done with HE and image analysis.The experimental data were analyzed with statictical analysis.Results: Fourty two fetuses without CDH were obtained in the control group.Seventeen feminine rats(1 rat was died by intragastric administration in the CDH group) in other groups produced 142 fetuses with 72 CDH(Abnormal rate was 50.70%).The lungs of CDH group fetuses showed marked abnormal pulmonary vascular remodeling and pulmonary hypoplasia,in contrast to improved pulmonary structure in that of vitmin A treated fetuses.Statistical differences of these morphologic parameters were found.Conclusion: The lungs of CDH group fetuses showed marked abnormal pulmonary vascular remodeling and pulmonary hypoplasia,in contrast to improved pulmonary structure in that of vitmin A treated fetuses.The effect of vitamin A has no difference from the effect of Dex.It is feasible for vitamin A to replace Dex in order to avoid the side effect of the Dex.