中性粒细胞在大鼠肾缺血再灌注造成肺损伤中的作用研究

目的探讨中性粒细胞在大鼠肾缺血再灌注造成肺损伤中的作用。方法SD大鼠40只，随机分为对照组（假手术组）、缺血30min再灌注60min组（I30’＋R60＇组），缺血60min再灌注60min组（I60’＋R60’组），缺血90mib再灌注60min组（I90＇＋R60’组），缺血120min再灌注60min组（I120’＋R60’组），测定各组血浆中肌酐（Cr）、尿素氮（BUN）、肿瘤坏死因子-α（TNF-α）、中性粒细胞弹性蛋白酶（NE）含量；支气管肺泡灌洗液（BALF）中TNF-α、NE的含量。结果肾脏缺血再灌注（I／R）导致肾脏、肺损伤，中性粒细胞在其中发挥重要作用。随着肾缺血时间延长，再灌注后肾功能严重损害，血浆Cr、BUN含量、肾系数逐渐升高，差异有统计学意义（P〈0．05）。血浆、支气管肺泡灌洗液（BALF）中TNF-α含量逐渐升高，炎症反应加重，差异有统计学意义（P〈0．05）。血浆、BALF中中性粒细胞弹性蛋白酶（NE）高于对照组（P〈0．05），组织破坏程度逐渐加重。病理观察结果显示，肾缺血再灌注（I／R）后，肾组织和肺组织有损伤性改变。结论肾脏I／R损伤可造成肺功能损伤，损伤机制与中性粒细胞的活化引发的非特异性局部或全身炎性反应有关。

Study on Polymorphonuclear Neutrophil and Lung Injury in Rabbits Following Renal Ischemia-reperfusion

Objective To study polymorphonuclear neutrophil and lung injury in rabbits following renal ischemia-reperfusion. Methods A model of renal I/R injury was established by imitation. Forty healthy SD rats were randomly divided into 5 groups as following（n=8） ： the control group （the group of sham operation）, 60min reperfusion following ischemia 30min （I30＇ ＋R60＇group）, 60rain reperfusion following ischemia 60min （I60＇＋R60＇group）, 60min reperfusion following ischemia 90min （I90＇＋R60＇group）,60min reperfusion following ischemia 120min （I120＇＋R60＇group）. In each group the rats were killed to obtain samples of pulmo at the specified time points. The contents of Cr, BUN, TNF-α, NE in blood,TNF-α, NE in BALF were observed in each group. Results Polymorphonuclear neutrophil play a important role in lung injury resulted by significant renal ischemia-reperfusion. With the extension of schemia-reperfusion, comparing with BUN and Cr in blood increased significantly in every control groups （P〈0. 01）. The content of TNF-α in blood and BALF increased in four control groups, especially in the latter two groups （P〈0. 01）. NE in blood and BALF have increased in every control groups（P〈0. 05）. There were change of injury in kidney and pulmonary by pathological section. Conclusions Kidney ischemia-reperfusion can induce injury to pulmonary in the early stage of reperfusion . The results suggested that PMN involved in the forming of pulmonary tissue injury after kidney ischemia-reperfusion underlying local and systemic inflammatory reaction.