• 解放軍總醫(yī)院南樓呼吸科( 北京 100853)通訊作者: 俞森洋, E-mail: senyangyu@ sina. com#研究生, 就讀于解放軍總醫(yī)院;

目的  觀察不同潮氣量通氣對脂多糖所致大鼠急性肺損傷的影響, 以及谷氨酰胺的防護作用。方法  將30 只健康雄性SD大鼠隨機分為三組。實施麻醉和氣管切開后, 氣管內注入脂多糖( LPS) 5 mg/kg, 接小動物通氣機進行機械通氣, A 組實施常規(guī)潮氣量通氣, B 組實施大潮氣量通氣,C 組大潮氣量通氣前1 h靜脈注入谷氨酰胺干預。每小時行1 次動脈血氣分析。通氣4 h 后頸動脈放血處死大鼠。測定全肺濕重, 并計算肺系數( 肺濕重/ 體重×100) 。測定BALF 中白細胞及中性粒細胞計數、蛋白含量、TNF-α、IL-6 和中性粒細胞趨化因子1( CINC-1) 水平, 肺組織勻漿髓過氧化物酶( MPO) 、超氧化物歧化酶( SOD) 水平。結果  B 組大鼠PaO2 值、肺組織SOD 水平較A 組顯著下降,肺系數、BALF中白細胞及中性粒細胞計數、蛋白含量、TNF-α、IL-6、CINC-1 水平、肺組織MPO 水平較A 組顯著增高; C 組大鼠PaO2 值、肺組織SOD 水平較B 組顯著升高, 肺系數、BALF 中白細胞及中性粒細胞計數、蛋白含量、TNF-α、IL-6、CINC-1 水平、肺組織MPO水平較B 組顯著下降。結論  大潮氣量通氣能加重脂多糖所致大鼠急性肺損傷, 而谷氨酰胺對此有較明顯的防護作用。

引用本文： 李金明,孫寶君,俞森洋,劉慶輝. 大潮氣量通氣加重脂多糖所致急性肺損傷及谷氨酰胺的防護作用. 中國呼吸與危重監(jiān)護雜志, 2010, 9(2): 168-171. doi: 復制

1. Caruso P. Ventilator-induced lung injury distribution: the key to understanding injury mechanisms. Am J Respir Crit Care Med,2007, 175 : 95-96.
2. Belperio JA, Keane MP, Lynch JP 3rd, et al. The role of cytokines during the pathogenesis of ventilator-associated and ventilatorinduced lung injury. Semin Respir Crit Care Med, 2006 , 27: 350 -364 .
3. Halbertsma FJ, Vaneker M, Scheffer GJ, et al. Cytokines and biotrauma in ventilator-induced lung injury: a critical review of the literature. Neth J Med, 2005, 63 : 382-392.
4. Lee WL, Slutsky AS. Ventilator-induced lung injury and recommendations for mechanical ventilation of patients with ARDS.Semin Respir Crit Care Med, 2001 , 22: 269 -280.
5. 劉曉青, 鐘南山, 江華. 谷氨酰胺是否有雙相免疫調節(jié)作用: 研究證據分析. 中國臨床營養(yǎng)雜志, 2003 , 11: 133-135.
6. Yeh CC, Kao SJ, Lin CC, et al. The immunomodulation of endotoxininduced acute lung injury by hesperidin in vivo and in vitro. Life Sci, 2007, 80: 1821-1831.
7. Su CF, Yang FL, Chen HI. Inhibition of inducible nitric oxide synthase attenuates acute endotoxin-induced lung injury in rats. Clin Exp Pharmacol Physiol, 2007 , 34: 339-346.
8. 武慶平, 劉萍, 王立奎, 等. 不同潮氣量通氣對大鼠呼吸機相關性肺損傷模型的影響. 華中科技大學學報( 醫(yī)學版) , 2006, 35 :511-514.
9. 劉慶輝, 俞森洋. 乙酰半胱氨酸對通氣機所致大鼠肺損傷的保護作用. 中國呼吸與危重監(jiān)護雜志, 2002, 1: 23-26.
10. 連寧芳, 朱蕾. 機械通氣的并發(fā)癥. 中國呼吸與危重監(jiān)護雜志,2004, 3: 144 -146.
11. Ramos CD, Heluy-Neto NE, Ribeiro RA, et al. Neutrophil migration induced by IL-8-activated mast cells is mediated by CINC-1 .Cytokine, 2003 , 21: 214-223.
12. Lorenzetti BB, Veiga FH, Canetti CA, et al. Cytokine-induced neutrophil chemoattractant 1 ( CINC-1 ) mediates the sympathetic component of inflammatory mechanical hypersensitivitiy in rats. Eur Cytokine Netw, 2002 , 13 : 456-461.
13. Kupczyk M, Bocheńska-Marciniak M, Górski P, et al.Myeloperoxidase ( MPO) as a marker of neutrophil influx into nasalmucosa after recombinant IL-8 challenge. Pneumonol Alergol Pol,2002, 70: 544-549 .
14. 謝繼青, 李玉華, 楊春梅, 等. 超氧化物歧化酶的藥理作用. 中國生化藥物雜志, 2009, 30: 72 -75 .
15. Mosser DD, Caron AW, Bourget L, et al. The chaperone function of hsp70 is required for protection against stress-induced apoptosis.Mol Cell Biol, 2000, 20: 7146-7159.
16. Ravagnan L, Gurbuxani S, Susin SA, et al. Heat-shock protein 70 antagonizes apoptosis-inducing factor. Nat Cell Biol, 2001, 3: 839 -843.
17. Vreugdenhil HA, Haitsma JJ, Jansen KJ, et al. Ventilator-induced heat shock protein 70 and cytokine mRNA expression in a model of lipopolysaccharide-induced lung inflammation. Intensive Care Med,2003, 29: 915-922 .
18. Amores-Sánchez MI, Medina MA. Glutamine, as a precursor of glutathione, and oxidative stress. Mol Genet Metab, 1999, 67: 100 -105.
19. Spittler A, Winkler S, G tzinger P, et al. Influence of glutamine on the phenotype and function of human monocytes. Blood, 1995, 86 :1564-1569.
20. Furukawa S, Saito H, Inoue T, et al. Supplemental glutamine augments phagocytosis and reactive oxygen intermediate production by neutrophils and monocytes from postoperative patients in vitro.Nutrition, 2000, 16: 323-329.
21. Wallin RP, Lundqvist A, MoréSH, et al. Heat-shock proteins as activators of the innate immune system. Trends Immunol, 2002, 23 :130-135.
  1. 1. Caruso P. Ventilator-induced lung injury distribution: the key to understanding injury mechanisms. Am J Respir Crit Care Med,2007, 175 : 95-96.
  2. 2. Belperio JA, Keane MP, Lynch JP 3rd, et al. The role of cytokines during the pathogenesis of ventilator-associated and ventilatorinduced lung injury. Semin Respir Crit Care Med, 2006 , 27: 350 -364 .
  3. 3. Halbertsma FJ, Vaneker M, Scheffer GJ, et al. Cytokines and biotrauma in ventilator-induced lung injury: a critical review of the literature. Neth J Med, 2005, 63 : 382-392.
  4. 4. Lee WL, Slutsky AS. Ventilator-induced lung injury and recommendations for mechanical ventilation of patients with ARDS.Semin Respir Crit Care Med, 2001 , 22: 269 -280.
  5. 5. 劉曉青, 鐘南山, 江華. 谷氨酰胺是否有雙相免疫調節(jié)作用: 研究證據分析. 中國臨床營養(yǎng)雜志, 2003 , 11: 133-135.
  6. 6. Yeh CC, Kao SJ, Lin CC, et al. The immunomodulation of endotoxininduced acute lung injury by hesperidin in vivo and in vitro. Life Sci, 2007, 80: 1821-1831.
  7. 7. Su CF, Yang FL, Chen HI. Inhibition of inducible nitric oxide synthase attenuates acute endotoxin-induced lung injury in rats. Clin Exp Pharmacol Physiol, 2007 , 34: 339-346.
  8. 8. 武慶平, 劉萍, 王立奎, 等. 不同潮氣量通氣對大鼠呼吸機相關性肺損傷模型的影響. 華中科技大學學報( 醫(yī)學版) , 2006, 35 :511-514.
  9. 9. 劉慶輝, 俞森洋. 乙酰半胱氨酸對通氣機所致大鼠肺損傷的保護作用. 中國呼吸與危重監(jiān)護雜志, 2002, 1: 23-26.
  10. 10. 連寧芳, 朱蕾. 機械通氣的并發(fā)癥. 中國呼吸與危重監(jiān)護雜志,2004, 3: 144 -146.
  11. 11. Ramos CD, Heluy-Neto NE, Ribeiro RA, et al. Neutrophil migration induced by IL-8-activated mast cells is mediated by CINC-1 .Cytokine, 2003 , 21: 214-223.
  12. 12. Lorenzetti BB, Veiga FH, Canetti CA, et al. Cytokine-induced neutrophil chemoattractant 1 ( CINC-1 ) mediates the sympathetic component of inflammatory mechanical hypersensitivitiy in rats. Eur Cytokine Netw, 2002 , 13 : 456-461.
  13. 13. Kupczyk M, Bocheńska-Marciniak M, Górski P, et al.Myeloperoxidase ( MPO) as a marker of neutrophil influx into nasalmucosa after recombinant IL-8 challenge. Pneumonol Alergol Pol,2002, 70: 544-549 .
  14. 14. 謝繼青, 李玉華, 楊春梅, 等. 超氧化物歧化酶的藥理作用. 中國生化藥物雜志, 2009, 30: 72 -75 .
  15. 15. Mosser DD, Caron AW, Bourget L, et al. The chaperone function of hsp70 is required for protection against stress-induced apoptosis.Mol Cell Biol, 2000, 20: 7146-7159.
  16. 16. Ravagnan L, Gurbuxani S, Susin SA, et al. Heat-shock protein 70 antagonizes apoptosis-inducing factor. Nat Cell Biol, 2001, 3: 839 -843.
  17. 17. Vreugdenhil HA, Haitsma JJ, Jansen KJ, et al. Ventilator-induced heat shock protein 70 and cytokine mRNA expression in a model of lipopolysaccharide-induced lung inflammation. Intensive Care Med,2003, 29: 915-922 .
  18. 18. Amores-Sánchez MI, Medina MA. Glutamine, as a precursor of glutathione, and oxidative stress. Mol Genet Metab, 1999, 67: 100 -105.
  19. 19. Spittler A, Winkler S, G tzinger P, et al. Influence of glutamine on the phenotype and function of human monocytes. Blood, 1995, 86 :1564-1569.
  20. 20. Furukawa S, Saito H, Inoue T, et al. Supplemental glutamine augments phagocytosis and reactive oxygen intermediate production by neutrophils and monocytes from postoperative patients in vitro.Nutrition, 2000, 16: 323-329.
  21. 21. Wallin RP, Lundqvist A, MoréSH, et al. Heat-shock proteins as activators of the innate immune system. Trends Immunol, 2002, 23 :130-135.