不同潮气量机械通气对大鼠支气管和肺组织细胞凋亡的影响

南方医科大学学报 ›› 2005, Vol. 25 ›› Issue (05): 508-512.

不同潮气量机械通气对大鼠支气管和肺组织细胞凋亡的影响

胡国栋¹, 蔡绍曦¹, 陈英华², 高枫¹

1. 南方医科大学南方医院呼吸科, 广东, 广州, 510515;
2. 南方医科大学组织胚胎学教研室, 广东, 广州, 510515

出版日期:2005-05-20 发布日期:2005-05-20
基金资助:
收稿日期:2004-12-6。
基金项目:国家自然科学基金(30270593);广东省自然科学基金(A001031);广东省名医工程(http://www.med.sti.gd.cn/index.htm)
作者简介:胡国栋(1976- ),男,在读硕士生,电话:020-61641571,E-mail:hgd77223@fimmu.com.
通讯作者:蔡绍曦,科主仟,教授,主要从事支气管哮喘诊治、危重病救治等研究,电话:020-61641571

Effect of different tidal volume ventilation on rat bronchial and alveolar epithelial cell apoptosis

HU Guo-dong¹, CAI Shao-xi¹, CHEN Ying-hua², GAO Feng¹

1. 南方医科大学南方医院呼吸科, 广东, 广州, 510515;
2. 南方医科大学组织胚胎学教研室, 广东, 广州, 510515

Online:2005-05-20 Published:2005-05-20

摘要/Abstract

摘要： 目的研究不同潮气量机械通气对大鼠支气管和肺组织细胞凋亡的影响,初步探讨细胞凋亡在机械通气所致肺损伤中的作用机制及其意义.方法将30只健康雄性SD大鼠随机分成A、B、C 3组,气管切开、插管后,分别给予不同潮气量(VT)机械通气4h(A组:VT=10 ml/kg;B组:VT=20 ml/kg;C组:VT=40 ml/kg),采用光镜和电镜观察3组大鼠肺组织的病理和超微结构改变,用湿干重比值来比较肺水肿的程度,用脱氧核糖核苷酸末端转移酶介导的末端标记法检测损伤的肺组织中细胞凋亡的发生程度,用免疫组织化学技术检测肺组织caspase-3酶的表达及组织分布.结果依次给予A、B、C 3组以小、中、大3种不同的潮气量机械通气后,3组动物大体和病理改变依次加重,肺湿干重比值依次增高,支气管和肺组织细胞凋亡明显增加(P<0.01);在细胞凋亡执行阶段起中心作用的caspase-3酶在肺泡上皮细胞、血管内皮细胞的胞浆和核中的表达也明显增强,尤其以在支气管上皮caspase-3酶的表达增强更为显著.结论给予3组动物3种不同潮气量机械通气后,动物病理改变和细胞凋亡数量及凋亡效应酶caspase-3的变化趋势基本一致,推测细胞凋亡在大潮气量机械通气引起的肺损伤中起重要作用.

Abstract: Objective To investigate the changes in bronchial and alveolar epithelial cell apoptosis after mechanical ventilation with different tidal volumes and explore the mechanism and significance of cell apoptosis in ventilation-induced lung injury.Methods Thirty healthy male Sprague-Dawley rats were randomly divided into groups A, B and C to receive tracheotomy under anesthesia for ventilation with different tidal volumes (VT) for 4 h (VT of 10 ml/kg in group A, 20 ml/kg in group B and 40 ml/kg in group C). Lung histopathology was assessed after the ventilation and compared between the 3 groups. The severity of lung injury and bronchial epithelial edema was evaluated, and the extent and location of cell apoptosis in the bronchus and lung tissues were studied by transferase d-UTP end-labeling (TUNEL) assay and immunohistochemistry.Results After mechanical ventilation for 4 h, lung injury and bronchial epithelial edema increased with the increment of VT. By TUNEL assay, the apoptosis index of both alveolar and bronchial epithelial cells was found to increase with VT. Immunohistochemical study identified enhanced caspase-3 expression in the cytoplasm and nuclei of airway and alveolar epithelial cells and vascular endothelial cells in rats with high VT ventilation, and the enhancement was especially obvious in the bronchial epithelial cells. Conclusion Mechanical ventilation with different VTs causes consistent changes in histopathology, cell apoptosis and caspase-3 expression in rats, which support the presumption that cell apoptosis plays an important role in the pathogenesis of high VT ventilation-induced lung injury.

中图分类号:

R563.9

胡国栋¹, 蔡绍曦¹, 陈英华², 高枫¹. 不同潮气量机械通气对大鼠支气管和肺组织细胞凋亡的影响[J]. 南方医科大学学报, 2005, 25(05): 508-512.

HU Guo-dong¹, CAI Shao-xi¹, CHEN Ying-hua², GAO Feng¹. Effect of different tidal volume ventilation on rat bronchial and alveolar epithelial cell apoptosis[J]. Journal of Southern Medical University, 2005, 25(05): 508-512.

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