慢性支气管炎与肺气肿大鼠气道炎症的实验研究

目的　探讨慢性支气管炎 (慢支炎 )与肺气肿气道炎症的特点及红霉素对气道炎症的干预作用。方法　将 43只雄性Wistar大鼠随机分为正常组 ,对照组 ,慢支炎组 ,慢支炎并肺气肿组 ,低、高剂量红霉素治疗组及低、高剂量红霉素预防组共 8组 ,应用气管内注入脂多糖和烟熏的方法复制慢支炎、慢支炎并肺气肿动物模型 ,收集支气管肺泡灌洗液 (BALF)进行细胞学计数和分类检查 ,并对大鼠肺脏进行病理学检查。结果　慢支炎组BALF中有核细胞数及中性粒细胞分类计数较对照组显著增高 (P <0 0 5) ;慢支炎并肺气肿组BALF中有核细胞数、中性粒细胞分类计数及单核巨噬细胞绝对数均显著增加 ,肺泡间隔破坏 ,肺气肿形成。慢支炎组、慢支炎并肺气肿组与正常组比较病理总分均显著增高 (P <0 0 1 ) ,慢支炎并肺气肿组病理积分较慢支炎组增高。红霉素治疗组及预防组BALF中中性粒细胞数显著降低 ,病理总分也有不同程度降低。结论　多种炎性细胞 ,尤其是中性粒细胞、肺泡巨噬细胞在慢支炎和肺气肿气道炎症中起重要作用 ,随病情加重 ,肺泡巨噬细胞浸润更加明显 ;红霉素对慢支炎与肺气肿气道炎症具有一定的防治作用 ,其疗效与剂量和疗程有关 ,其机理与抑制慢性阻塞性肺疾病气道炎症中性粒细胞聚集和活化有关

Experimental study on airway inflammation in rats with chronic bronchitis and emphysema

Objective To investigate the character of airway inflammation and the protective and therapeutic effects of erythromycin(EM)on airway inflammation in rats with chronic bronchitis(CB)and emphysema Methods CB and emphysema models were established by intratracheal instillation of lipoplysacchairde(LPS)twice and exposed to cigarette smoke daily Total and differential cell counts in bronchoalveolar lavage fluid(BALF)were observed,and the airway and lung pathomorphological changes were analysed Results The numbers of white cell and neutrophils in BALF and pathologic integral obtained from CB group and CB with emphysema group were higher than those from control group( P <0 05) Moreover,the number of BALF alveolar monocyte macrophage and pathologic integral were significantly higher and alveolar walls were destructed and emphysema was more extensive in CB with pulmonary emphysema group than those in CB group.The number of neutrophils and pathologic integral were significantly decreased after EM treatment Conclusions Many inflammatory cells especially neutrophils and pulmonary alveolar macrophages might play important roles in the airway inflammation of CB and emphysema,and the number of pulmonary alveolar macrophages was increased with periodic worsening of the disease EM may partly prevent the development of airway inflammation in CB and emphysema by inhibiting the neutrophils accumulation in the lung and the roles were positively correlated with the dose and period of treatment