急性肺血栓栓塞症兔TNF-α、IL-8、IL-10水平及地塞米松的影响

目的:探讨兔急性肺血栓栓塞症(PTE)时血浆及支气管肺泡灌洗液(BALF)中TNF-α,IL-8、IL-10的水平和地塞米松(Dex)的影响。方法:采用自体血栓回输法建立兔急性PTF模型。36只兔随机分为对照组、Dex治疗组和PTE模型组。用ELISA方法检测上述细胞因子(CK)水平,术毕肺组织行病理观察。结果:栓塞后上述CK均有升高,治疗后TNF-α、IL-8均有下降,IL-10变化不明显。组织病理学可见栓塞后肺动脉内血栓形成,肺组织萎缩、出血、炎性反应明显,Dex治疗后肺组织病理改变明显减轻。结论:PTE后促炎性CK在引起肺部炎性反应和肺组织及肺动脉病损中起了重要作用,抗炎治疗可以明显减轻CK引起的这种损伤。抗炎治疗能降低PTE急性期病死率,改善远期预后,CK可能起了很重要的作用。

Level of TNF-α、IL-8、IL-10 and Effect of Dexamethasone in Acute Pulmonary Thromboembolism

Objective: To discuss levels of tumor necrosis factor-α(TNF-α),inter-leukin-8(IL-8), interleukin-10(IL-10) in plasma also the bronchial alveolar lavage fluid (BALF) and the effect of dexamethasone (Dex) in acute pulmonary thromboembolism (PTE). Method: PTE model of rabbits were established by intravenous injection of antogenous blood clots. 36 rabbits were randomly divided into the control(CTL) group, Dex treatiment group and PTE model group. By enzyme-linked immunosorbent assay(ELISA) to measure the levels of these cytokines(CK). At the end, the rabbits were sacrificed and lung removed for histopathologic with microscope. Results: After embolization, the CK were elevatory;but, after Dex treatment, TNF-α and IL-8 droped and the changes of IL-10 weren't in evidence. Histopathologic analysis: after embolization, thrombi were formed in pulmonary artery that the tissue atrophy, hemorhages and inflammatory reaction obviously, thus, after Dex treatment, the changes of lung tissue are lightened obviously. Con- clusion : The pro-inflammatory cytokines play an important role in the inflammatory injury of lung tissue and artery. Anti-inflammatory therapy can marked lighten acute lung injury and could fall acute mortality for improve prognosis in the long date. In these effects, CK could play an important role.