肺复张方法和潮气量对急性呼吸窘迫综合征家兔肺泡灌洗液中细胞因子的影响

目的探讨肺复张方法和潮气量对急性呼吸窘迫综合征（ARDS）家兔肺泡灌洗液（BALF）中TNF-α、IL-8及IL-10的影响。方法建立ARDS家兔模型,用ELISA法检测不同组别家兔BALF中的TNF-α、IL-8及IL-10,并比较检测结果。结果呼气末正压（PEEP）递增法组BALF中的TNF-α、IL-8显著低于控制性肺膨胀（SI）组及ARDS组,而IL-10显著高于SI组及ARDS组（均P〈0.01）。不同潮气量中,小潮气量组BALF中的TNF-α、IL-8显著低于其他潮气量组,而IL-10显著高于其他潮气量组（均P〈0.01）。PEEP递增法组中,小潮气量组BALF中的TNF-α、IL-8显著低于其他潮气量组,而IL-10显著高于其他潮气量组（均P〈0.01）。结论 PEEP递增法＋小潮气量可抑制ARDS家兔BALF中的TNF-α、IL-8的释放,增加IL-10的释放,减轻肺内炎症反应。

Influence of Lung Recruitment and Tidal Volume on Cytokines in BALF of Rabbits with ARDS

Objective To determine changes and significance of different lung recruitment and tidal volume on TNF-α,IL-8 and IL-10 in bronchoalveolar lavage fluids（BALF） of rabbits with acute respiratory distress syndrome（ARDS）.Methods After ARDS rabbit model was developed.TNF-α,IL-8 and IL-10 in different groups of rabbits BALF were measured by ELISA and comparison of determined results was performed.Results TNF-α,IL-8 in positive end-expiratory pressure（PEEP） increase group were significantly lower than those in the suatained inflation（SI） group and the ARDS group,but IL-10 was obviously higher than that in the SI group and the ARDS group（P0.01）.In different tidal volume groups,TNF-α,IL-8 of BALF in small tidal volume group was significantly lower than those in the other groups,but IL-10 was obviously higher than that in the other tidal volume groups（P0.01）.In PEEP increase groups,TNF-α,IL-8 of BALF in small tidal volume group were significantly lower than those in the other tidal volume groups,IL-10 was obviously higher than that in the other tidal volume groups（P0.01）.Conclusion PEEP increase and small tidal volume inhibit the release of TNF-α,IL-8 in BALF of ARDS rabbits,increase the release of IL-10,and release inflammatory response within the lungs.