目的观察肠淋巴液引流对失血性休克大鼠早期急性肺损伤的影响。方法 Wistar雄性大鼠均分为假手术组、休克组[复制失血性休克模型,维持低血压(40±2)mmHg]、休克+引流组(复制失血性休克模型,自低血压1 h引流休克肠淋巴液)。在低血压2 h或相应时间,经腹主动脉取血后,左肺行支气管肺泡灌洗制备支气管肺泡灌洗液(BALF),进行细胞计数,检测BALF与血浆总蛋白,计算肺通透性指数(LPI),右肺上叶测定肺干/湿重(D/W),右肺下叶观察组织学变化,右肺中叶与副叶制备组织匀浆检测干扰素γ(IFN-γ)与白介素-4(IL-4)含量。结果休克组肺组织可见肺间隔增宽、肺泡腔缩小,休克+引流组肺组织损伤程度明显轻于休克组;休克组BALF细胞总数、LPI均显著高于假手术组,D/W显著低于假手术组(P〈0.05,P〈0.01),休克+引流组的BALF细胞总数、LPI均显著低于休克组,D/W显著高于休克组(P〈0.05,P〈0.01),且BALF细胞总数高于假手术组(P〈0.01);休克组肺组织IFN-γ、IL-4含量以及IFN-γ/IL-4均显著高于假手术组(P〈0.05,P〈0.01),休克+引流组肺组织IFN-γ与IL-4含量均显著低于休克组(P〈0.01)。结论肠淋巴液引流可减轻失血性休克早期肺损伤,其机制与降低肺组织的炎症反应有关。
【Objective】 To observe the effects of mesenteric lymph drainage on early lung injury in hemorrhagic shock(HS) rats.【Methods】 Wistar male rats were randomly divided into sham group,shock group(establishing HS model,to maintain low blood pressure 40±2 mmHg),shock + drainage group(establishing HS model,draining the mesenteric lymph from low blood pressure 1h).At 2 h or corresponding times,the bronchoalveolar lavage fluid(BALF) was obtained from the left lung using bronchoalveolar lavage after collecting blood sample through the aorta abdominalis,and the cell numbers in BALF were detected.Total protein in BALF and plasma was detected for calculating the lung permeability index(LPI);the ratio of dry/wet weight(D/W) was detected in the superior lobe of right lung;the histological change was observed in inferior lobe of right lung;the contents of interferon-γ(IFN-γ) and interleukin-4(IL-4) were examined in homogenate from middle and accessory lobes of right lung.【Results】 The widened interval and shrunken alveoli in the pulmonary tissue were found in shock group,the degree of lung damage in shock + drainage group was much light than shock group.In shock group,the cells in BALF and LPI were increased significantly,the D/W was lower than that of sham group,respectively(P 0.05,P 0.01);in the shock + drainage group,the cells in BALF and LPI were decreased,the D/W was higher significantly than shock group,respectively(P 0.05,P 0.01),and the cells in BALF was higher compared with sham group(P 0.01).The contents of IFN-γ,IL-4 and the IFN-γ/IL-4 in pulmonary tissue of shock group were significantly higher than those in sham group(P 0.05,P 0.01);and the contents of IFN-γ and IL-4 in shock + drainage group were significantly lower than that of shock group(P 0.01).【Conclusion】 The results indicated that mesenteric lymph drainage reduces early lung injury in HS,and it's mechanism is concerned with reducing the inflammatory reaction in lung.