参麦注射液对机械通气相关肺损伤大鼠肺炎性反应的影响

目的：探讨参麦注射液对机械通气相关肺损伤（VILI）大鼠肺炎性反应的影响。方法：健康成年雄性SD大鼠30只,体质量300~350 g,随机分为3组（n=10）：常规潮气量通气组（TV组,潮气量8 m L/kg）、大潮气量通气组（HV组,潮气量40 m L/kg）、大潮气量通气＋参麦注射液组（HS组）。HS组于机械通气前30min通过尾静脉注射10 m L/kg参麦注射液。机械通气4 h后抽取股动脉血行血气分析,留取肺组织和支气管肺泡灌洗液（BALF）,计算大鼠肺湿干重比（W/D值）和肺泡通透性指数（PPI）,测定BALF中肿瘤坏死因子（TNF-α）、白细胞介素1β（IL-1β）、白细胞介素10（IL-10）浓度,测定肺组织匀浆Na＋-K＋-ATP酶活性,观察肺组织病理学变化。结果：与TV组相比,机械通气4 h后HV组Pa O2下降,W/D值和PPI升高,BALF中TNF-α、IL-1β及IL-10浓度增加,TNF-α/IL-10比值升高,Na＋-K＋-ATP酶活性降低（P〈0.05）,肺组织出现明显损伤;与HV组相比,HS组Pa O2升高,W/D值、PPI及TNF-α/IL-10比值降低,TNF-α及IL-1β浓度降低,IL-10浓度、Na＋-K＋-ATP酶活性增高（P〈0.05）,肺组织损伤程度减轻。结论：参麦注射液可减轻炎性反应,改善肺水代谢,从而减轻VILI。

Effect of Shenmai injection on inlfammatory response of rats with ventilator-induced lung injury

Objective： To investigate the effect of Shenmai injection on inlfammatory response of rats with ventilator-induced lung injury （VILI）.Methods： Thirty healthy adult male SD rats weighting 300~350 g were randomly divided into 3 groups （n=10 in each）： group TV （traditional tidal volume, VT=8 mL/kg）, group HV （high tidal volume, VT=40 mL/kg）, group HS （pretreated with Shenmai injection 10 mL/kg and high tidal volume 40 mL/kg）. After 4-hour mechanical ventilation, arterial blood samples were obtained for blood gas analysis be-fore the animals were sacriifced. The lungs were removed for observation under microscopic examination, and bronchoaveolar lavage lfuid （BALF） was collected. W/D lung weight ratio and pulmonary permeability index （PPI） were calculated, also TNF-α, IL-1β, IL-10 in BALF and Na＋-K＋-ATPase activity in lung tissue were mea-sured.Results： After 4-hour ventilation, compared with group TV, PaO2 was signiifcantly decreased, PPI, W/D and TNF-α/IL-10 ratio was increased, the levels of TNF-α, IL-1β, IL-10 in BALF were increased and Na＋-K＋-ATPase activity in lung tissue were decreased in group HV （P〈0.05）. PaO2 was signiifcantly higher, PPI, W/D and TNF-α/IL-10 ratio were decreased, TNF-α, IL-1β in BALF were decreased, the level of IL-10 in BALF and Na＋-K＋-ATPase activity in lung tissue were higher in group HS as compared to group HV （P〈0.05）. The lung tissues injury was severe in group HV, which could be obviously alleviated in group HS.Conclusion： Shenmai injection can attenuate ventilation-induced lung injury in rats, whose mechanism may be related to alleviate the inlfammatory response and improve lung water metabolism in VILI.