缺血预处理对肺缺血再灌注损伤中细胞因子生成的影响

目的　探讨缺血预处理 (IPC)对肺缺血再灌注 (I/R)损伤的保护作用及其对细胞因子生成的影响。　方法　 36只大白兔分为 3组 :对照组、I/R组和IPC组。通过阻断左肺门造成兔在体I/R损伤 ,观察IPC对肺I/R损伤的保护作用 ,指标为肺组织湿干重比、肺通透性指数及支气管肺泡灌洗液(BALF)中白细胞分类计数 ;以双抗体夹心酶联免疫吸附试验法检测血清中肿瘤坏死因子α(TNFα)、白细胞介素 6(IL 6)、白细胞介素 8(IL 8)的含量。　结果　肺I/R损伤后 ,I/R组肺组织湿干重比、肺通透性指数及BALF中性粒细胞百分比分别为 9 73± 1 1 4、(41 62± 5 77)× 1 0 - 4和 (58 1± 1 0 0 ) % ;IPC组分别为 6 2 3± 0 69、(2 0 31± 4 0 3)× 1 0 - 4和 (2 3 8± 5 2 ) % ,两组差异有极显著意义 (P <0 0 1 )。I/R组血清TNFα、IL 6和IL 8含量分别为 (0 90 78± 0 1 0 6 2 )、(0 2 1 3 7± 0 0 598)和 (0 72 1 1± 0 0 979)ng/ml,IPC组分别为 (0 7478± 0 0 843)、(0 1 2 71± 0 0 0 89)和 (0 590 3± 0 0 746)ng/ml,较I/R组显著降低 (P <0 0 1 )。　结论　IPC对I/R损伤有显著的保护作用 ,机理可能与其抑制炎性细胞因子TNFα、IL 6和IL 8的合成和释放 ,从而减轻中性粒细胞的浸润与激活有关。

Effect of ischemic preconditioning on cytokines during lung ischemia-reperfusion injury

OBJECTIVE: To investigate the protective role of ischemic preconditioning (IPC) during lung ischemia-reperfusion (I/R) injury and its influence on inflammatory cytokine production. METHODS: In vivo I/R injury of rabbit was induced by blocking hilum of the left lung. The wet/dry ratio of the lung, lung permeability index and neutrophils percentage in bronchoalveolar lavage fluid (BALF) were detected as indexes of the lung injury. Serum levels of tumor necrosis factor alpha (TNFalpha), interleukin-6 (IL-6) and interleukin-8 (IL-8) were also detected using enzyme-linked immunosorbent assay. The protective role of IPC and its influence on inflammatory cytokine production were observed. RESULTS: The wet/dry ratio of the lung, lung permeability index and neutrophils percentage in BALF of I/R group were 9.73 +/- 1.14, (41.62 +/- 5.77) x 10(-4) and (58.1 +/- 10.0)% respectively. The IPC group indexes were 6.23 +/- 0.69, (20.31 +/- 4.03) x 10(-4) and (23.8 +/- 5.2)% respectively. There was a significant difference between the two groups (P < 0.01). Serum levels of TNFalpha, IL-6 and IL-8 of I/R group were (0.9078 +/- 0.1062), (0.2137 +/- 0.0598) and (0.7211 +/- 0.0979) ng/ml respectively. The IPC group indexes were (0.7478 +/- 0.0843), (0.1271 +/- 0.0089) and (0.5903 +/- 0.0746) ng/ml respectively, significantly lower than that of I/R group (P < 0.01). CONCLUSIONS: Lung IPC has a marked protection effect against I/R injury. The effect was related to its inhibition of inflammatory cytokines such as TNFalpha, IL-6 and IL-8, thus reducing activation and infiltration of neutrophils.