王正冠,李芮冰,徐舒敏,郭宇妮,陳文燕,陳宜鴻,王成彬
·軍事醫(yī)學(xué)·
葛根素聯(lián)合依達(dá)拉奉對(duì)煙霧所致吸入性肺損傷大鼠的治療作用
王正冠,李芮冰,徐舒敏,郭宇妮,陳文燕,陳宜鴻,王成彬
目的探討葛根素聯(lián)合依達(dá)拉奉對(duì)黑火藥煙霧所致吸入性肺損傷大鼠的治療作用。方法健康雄性Wistar大鼠40只,隨機(jī)分為正常對(duì)照組(N組)、吸入性肺損傷組(X組)、葛根素組(P組)、依達(dá)拉奉組(E組)、聯(lián)合用藥組(L組),每組8只。除正常對(duì)照組外,其余各組大鼠使用自制發(fā)煙裝置構(gòu)建吸入性肺損傷模型,依達(dá)拉奉組造模成功后30min腹腔注射依達(dá)拉奉(9mg/kg) 1次,第2天給藥1次,共2次;葛根素組造模成功后30min注射葛根素(100mg/kg) 1次,每天給藥1次,共6次;聯(lián)合用藥組造模成功后30min注射依達(dá)拉奉(9mg/kg) 1次,第2天給藥1次,共2次,注射葛根素(100mg/kg) 1次,每天給藥1次,共6次;正常對(duì)照組和吸入性肺損傷組腹腔注射生理鹽水(12ml/kg),每天1次,共6次。建模后第6天大鼠腹主動(dòng)脈取血,檢測(cè)動(dòng)脈血?dú)庵笜?biāo),并采用ELISA法測(cè)定血清腫瘤壞死因子-α(TNF-α)、白細(xì)胞介素6(IL-6)、IL-10的水平;留取肺組織制備肺組織勻漿,測(cè)定其蛋白含量及髓過(guò)氧化物酶(MPO)活性;取部分右肺組織,HE染色后觀(guān)察肺組織病理學(xué)變化。結(jié)果血?dú)夥治鼋Y(jié)果顯示,P﹑E﹑L組大鼠PaO2均明顯高于X組(P<0.05),且E、L組明顯高于P組(P<0.05),而L組PaCO2水平明顯低于X組及E組(P<0.05)。P﹑E﹑L組大鼠血清TNF-α、IL-6、IL-10水平及肺組織勻漿蛋白含量、MPO活性均明顯低于X組(P<0.05),且E﹑L組血清TNF-α、IL-6水平及肺組織勻漿蛋白含量、MPO活性明顯低于P組,血清IL-10水平明顯高于P組(P<0.05),L組血清TNF-α、IL-6水平及肺組織勻漿蛋白含量明顯低于E組(P<0.05)。光鏡觀(guān)察顯示,與X組比較,P﹑E、L組肺組織水腫減輕,炎性細(xì)胞浸潤(rùn)減少,且L組更顯著。結(jié)論依達(dá)拉奉聯(lián)合葛根素可能通過(guò)減少部分炎癥介質(zhì)的產(chǎn)生和釋放,減輕煙霧吸入性肺損傷大鼠體內(nèi)的炎癥反應(yīng),對(duì)肺組織起到一定的保護(hù)作用,且聯(lián)合用藥比單獨(dú)用藥的效果更好。
依達(dá)拉奉;葛根素;肺炎,吸入性
吸入性損傷是熱力或煙霧引起的呼吸道以及肺實(shí)質(zhì)損害[1],可導(dǎo)致嚴(yán)重的全身性病變,病死率較高,其中重度吸入性損傷的病死率高達(dá)80%以上。黑火藥被廣泛應(yīng)用于軍事和民用方面,如戰(zhàn)爭(zhēng)演習(xí)或煙花爆竹的燃放等,在其爆炸、燃燒過(guò)程中釋放的有毒氣體及粉塵顆粒會(huì)引發(fā)急性吸入性肺損傷,造成肺組織充血、水腫及炎性細(xì)胞浸潤(rùn)等。
依達(dá)拉奉(edaravone,ED)是一種新型的強(qiáng)效氧自由基清除劑,可抑制脂質(zhì)過(guò)氧化反應(yīng),從而抑制組織細(xì)胞的氧化損傷,在臨床上已被廣泛用于腦血管疾病的治療[2]。葛根素是從豆科植物野葛的干燥根中提純分離得到的異黃酮,臨床應(yīng)用于治療高血壓、冠心病心絞痛和糖尿病等[3]。依達(dá)拉奉與葛根素聯(lián)合應(yīng)用能否減輕吸入煙霧所致的肺損傷目前尚未見(jiàn)相關(guān)報(bào)道。本研究通過(guò)建立黑火藥煙霧所致肺損傷大鼠模型,探討依達(dá)拉奉聯(lián)合葛根素對(duì)煙霧吸入性肺損傷的保護(hù)作用及其機(jī)制。
1.1 主要試劑及儀器 依達(dá)拉奉(規(guī)格:5ml/10mg,南京先聲東元制藥有限公司,批準(zhǔn)文號(hào):國(guó)藥準(zhǔn)字H20031342),葛根素(規(guī)格:2ml,成都天臺(tái)山制藥有限公司,批準(zhǔn)文號(hào):國(guó)藥準(zhǔn)字H20057087),硝酸鉀、碳粉、硫黃粉(純度99.9%,200目,北京西四化工原料公司),大鼠腫瘤壞死因子-α(TNF-α)、白細(xì)胞介素6(IL-6)、IL-10 ELISA試劑盒(美國(guó)R&D公司),大鼠髓過(guò)氧化物酶(MPO)試劑盒(南京建成公司),微量加樣器(Eppendorf),光學(xué)顯微鏡(Olympus),酶標(biāo)儀(美國(guó)AWARENESS)。
1.2 動(dòng)物分組及處理 健康雄性Wistar大鼠40只,體重210~230g,由解放軍總醫(yī)院實(shí)驗(yàn)動(dòng)物中心提供,合格證號(hào):SCXK(京)2012-0001。大鼠于實(shí)驗(yàn)動(dòng)物中心清潔房中飼養(yǎng),溫度21~24℃,濕度50%~60%,晝夜12h節(jié)律,自由進(jìn)食、飲水。將40只大鼠隨機(jī)分為正常對(duì)照組(N組)、吸入性肺損傷組(X組)、葛根素組(P組)、依達(dá)拉奉組(E組)、聯(lián)合用藥組(L組),每組8只??瞻讓?duì)照組大鼠暴露于動(dòng)物煙熏箱的空氣中8min,葛根素組、依達(dá)拉奉組、聯(lián)合用藥組、煙熏組置于動(dòng)物煙熏箱中并在10g火藥產(chǎn)生的煙霧中暴露8min,制作黑火藥煙霧吸入性肺損傷大鼠模型。依達(dá)拉奉組造模成功后30min腹腔注射依達(dá)拉奉(9mg/kg) 1次,第2天給藥1次,共2次;葛根素組造模成功后30min注射葛根素(100mg/kg) 1次,每天給藥1次,共6次;聯(lián)合用藥組造模成功后30min注射依達(dá)拉奉(9mg/kg) 1次,第2天給藥1次,共2次,注射葛根素(100mg/kg) 1次,每天給藥1次,共6次;正常對(duì)照組和吸入性肺損傷組腹腔注射生理鹽水(12ml/kg),每天1次,共6次。所有大鼠均于暴露后第6天處死。
1.3 標(biāo)本采集及指標(biāo)檢測(cè) 按照1ml/kg劑量腹腔注射4%水合氯醛麻醉大鼠,暴露分離腹主動(dòng)脈后取動(dòng)脈血1ml,并于30min內(nèi)進(jìn)行動(dòng)脈血?dú)夥治?。取大鼠腹主?dòng)脈血,3000r/min離心15min后取上清液,采用ELISA法檢測(cè)血清中TNF-α、IL-6、IL-10的水平,具體操作參照試劑盒說(shuō)明書(shū)進(jìn)行。
打開(kāi)胸腔后觀(guān)察肺組織大體病理改變,取右肺后葉浸入4%中性甲醛溶液中固定24h,石蠟包埋,4μm連續(xù)切片,常規(guī)HE染色后光鏡下觀(guān)察病理組織學(xué)改變。取左肺組織及時(shí)保存于-80℃冰箱中待測(cè),檢測(cè)時(shí)以濾紙吸干肺組織表面污物,制備肺組織勻漿,用考馬斯亮藍(lán)法測(cè)定勻漿液中蛋白含量,參照試劑盒說(shuō)明書(shū)測(cè)定MPO活性。
1.4 統(tǒng)計(jì)學(xué)處理 采用SPSS 17.0軟件進(jìn)行統(tǒng)計(jì)分析。符合正態(tài)分布及方差齊的計(jì)量資料以表示,組間比較采用單因素方差分析(One-Way ANOVA),進(jìn)一步兩兩比較采用LSD-t檢驗(yàn)。P<0.05為差異有統(tǒng)計(jì)學(xué)意義。
2.1 動(dòng)脈血?dú)夥治鼋Y(jié)果 與N組比較,其余各組建模后第6天動(dòng)脈血?dú)庵笜?biāo)PaO2明顯降低,PaCO2明顯升高(P<0.05)。與X組比較,P組﹑E組﹑L組大鼠PaO2均明顯升高,且E組﹑L組PaO2高于P組(P<0.05)。L組大鼠PaCO2水平明顯低于X組及E組(P<0.05),而X組、P組﹑E組間比較差異無(wú)統(tǒng)計(jì)學(xué)意義(P>0.05,表1)。
表1 各組大鼠動(dòng)脈血?dú)庵笜?biāo)PaO2、PaCO2比較(mmHg,±s,n=8)Tab. 1 Comparison of arterial blood gas indexes (PaO2and PaCO2) in rats of five groups (mmHg,±s,n=8)
表1 各組大鼠動(dòng)脈血?dú)庵笜?biāo)PaO2、PaCO2比較(mmHg,±s,n=8)Tab. 1 Comparison of arterial blood gas indexes (PaO2and PaCO2) in rats of five groups (mmHg,±s,n=8)
(1)P<0.05 compared with N group; (2)P<0.05 compared with X group; (3)P<0.05 compared with P group; (4)P<0.05 compared with E group
47.97±5.98(1) 60.20±4.36(1)P 60.73±8.26(1)(2) 54.78±7.54(1)E 71.02±9.57(1)(2)(3) 57.92±8.22(1)L Group PaO2 PaCO2N 89.11±4.26 40.77±4.66 X 77.71±12.91(1)(2)(3) 49.18±7.13(1)(2)(4)Fvalue 26.107 11.205Pvalue <0.05 <0.05
2.2 血清TNF-α、IL-6 、IL-10水平比較 與N組比較,除P組IL-10水平無(wú)明顯改變外,其余各組建模后第6天血清TNF-α、IL-6、IL-10水平均明顯升高(P<0.05)。P組﹑E組﹑L組大鼠血清TNF-α、IL-6、IL-10水平均明顯低于X組(P<0.05),且E組﹑L組TNF-α、IL-6水平明顯低于P組,IL-10水平明顯高于P組(P<0.05),L組血清TNF-α、IL-6水平明顯低于E組(P<0.05,表2)。
表2 各組大鼠血清TNF-α、IL-6及IL-10水平比較(pg/ml,±s,n=8)Tab. 2 Comparison of serum TNF-α, IL-6 and IL-10 levels in rats of five groups (pg/ml,±s,n=8)
表2 各組大鼠血清TNF-α、IL-6及IL-10水平比較(pg/ml,±s,n=8)Tab. 2 Comparison of serum TNF-α, IL-6 and IL-10 levels in rats of five groups (pg/ml,±s,n=8)
(1)P<0.05 compared with N group; (2)P<0.05 compared with X group; (3)P<0.05 compared with P group; (4)P<0.05 compared with E group
Group TNF-α IL-6 IL-10 N 16.44±1.23 25.10±1.58 60.72±1.04 X 81.83±8.19(1) 78.12±6.00(1) 90.89±6.55(1)P 64.96±9.92(1)(2) 51.68±9.59(1)(2) 61.15±5.25(2)E 53.14±9.12(1)(2)(3) 42.08±4.28(1)(2)(3) 66.41±5.31(1)(2)(3)L 43.35±5.26(1)(2)(3)(4)32.99±4.27(1)(2)(3)(4)68.05±2.62(1)(2)(3)Fvalue 86.241 102.018 57.635Pvalue <0.05 <0.01 <0.05
2.3 肺組織蛋白含量及MPO活性比較 與N組比較,其余各組建模后第6天肺組織蛋白含量及MPO活性均明顯升高(P<0.05)。P組﹑E組﹑L組大鼠肺組織勻漿蛋白含量、MPO活性均明顯低于X組(P<0.05),且E組﹑L組明顯低于P組(P<0.05),L組肺組織勻漿蛋白含量明顯低于E組(P<0.05,表3)。
表3 各組大鼠肺組織勻漿蛋白含量及MPO活性比較(±s,n=8)Tab. 3 Comparison of MPO activity and protein content in lung tissue in rats of five groups (±s,n=8)
表3 各組大鼠肺組織勻漿蛋白含量及MPO活性比較(±s,n=8)Tab. 3 Comparison of MPO activity and protein content in lung tissue in rats of five groups (±s,n=8)
(1)P<0.05 compared with N group; (2)P<0.05 compared with X group; (3)P<0.05 compared with P group; (4)P<0.05 compared with E group
1.79±0.32(1)(2) 2.36±0.19(1)(2)E 1.03±0.16(1)(2)(3) 2.04±0.15(1)(2)(3)L 0.56±0.09(1)(2)(3)(4) 1.89±0.20(1)(2)(3)Fvalue 130.764 106.106Pvalue <0.01 <0.05 Group Protein (mg/ml) MPO (U/g) N 0.18±0.01 1.24±0.15 X 2.65±0.39(1) 3.04±0.21(1)P
2.4 肺組織病理學(xué)觀(guān)察結(jié)果 HE染色光鏡觀(guān)察顯示,N組大鼠肺泡結(jié)構(gòu)清晰完整,肺泡腔中未見(jiàn)白細(xì)胞或滲出液,肺泡壁光滑;X組可見(jiàn)明顯水腫和出血,肺泡間隔明顯不均,肺泡壁明顯充血、增厚,大量炎性細(xì)胞浸潤(rùn);P組可見(jiàn)肺泡仍有萎陷和擴(kuò)張,其大小形態(tài)尚不規(guī)則,氣道周?chē)M織增厚,毛細(xì)血管充血擴(kuò)張。與P組比較,E組﹑L組肺泡間質(zhì)炎性浸潤(rùn)均明顯減輕,肺泡腔內(nèi)未見(jiàn)滲出,組織水腫及肺泡萎陷程度進(jìn)一步減輕(圖1)。
吸入性損傷是熱力或煙霧引起的上呼吸道、氣管支氣管以及肺實(shí)質(zhì)損傷[4],煙霧中的化學(xué)刺激物為大小不等的顆粒和毒氣[5],會(huì)引起漸進(jìn)性細(xì)胞損傷和嚴(yán)重肺損傷,若不能得到及時(shí)診斷和治療,則有可能進(jìn)展為急性呼吸窘迫綜合征,引起膿毒癥等全身癥狀,最終導(dǎo)致多器官功能障礙綜合征甚至死亡。軍事行動(dòng)和訓(xùn)練中,常使用各種火藥煙霧,如阿富汗和伊拉克戰(zhàn)場(chǎng)上,美軍常使用各種煙霧發(fā)生器,以達(dá)到隱蔽己方免受攻擊的目的[6]。除軍事人員經(jīng)常接觸煙霧外,非戰(zhàn)時(shí)發(fā)生的民用設(shè)施火災(zāi)所致人員死亡中,約80%是由于吸入燃燒產(chǎn)生的有毒氣體而非燒傷導(dǎo)致死亡[7]。
目前用于急性肺損傷治療的藥物主要有血管舒張劑(采用吸入給藥,如一氧化氮吸入﹑前列環(huán)素吸入等)﹑腎上腺糖皮質(zhì)激素﹑非甾體類(lèi)抗炎藥物﹑酮康哇等,但總體療效不甚滿(mǎn)意,所以目前尚缺乏安全有效的早期干預(yù)和延緩疾病進(jìn)展的手段。依達(dá)拉奉是一種有效的氧自由基清除劑,能有效抑制脂質(zhì)過(guò)氧化反應(yīng)。在缺血再灌注后靜脈給予依達(dá)拉奉,能阻止大鼠腦水腫和腦梗死的進(jìn)展,并改善腦水腫和腦梗死所伴隨的神經(jīng)系統(tǒng)癥狀,通過(guò)抑制脂質(zhì)過(guò)氧化反應(yīng)減輕神經(jīng)元、神經(jīng)膠質(zhì)細(xì)胞和毛細(xì)血管內(nèi)皮細(xì)胞的損傷。葛根素是野生植物葛根中異黃酮的主要有效成分之一,可通過(guò)清除氧自由基、擴(kuò)張腦血管、增加腦灌注量來(lái)降低局灶性腦缺血再灌注引起的腦損傷。目前研究發(fā)現(xiàn),葛根素對(duì)腦缺血的保護(hù)作用主要包括以下幾個(gè)方面:①具有抗氧化、抗自由基作用;②抑制p53基因表達(dá),下調(diào)c-fos蛋白、caspase-3蛋白、Bax蛋白和上調(diào)bcl-2蛋白表達(dá),抗神經(jīng)細(xì)胞凋亡;③下調(diào)TNF-α、IL-1β的表達(dá),抑制局灶性腦缺血再灌注的炎癥反應(yīng);④改善腦微循環(huán)等[8-9]。
圖1 各組大鼠肺組織病理學(xué)觀(guān)察結(jié)果(HE×100)Fig. 1 Histopathology observation of lung tissues in rats of five groups (HE×100)
本研究使用自制的發(fā)煙裝置建立了黑火藥煙霧所致吸入性肺損傷模型[10],分別使用葛根素、依達(dá)拉奉、葛根素聯(lián)合依達(dá)拉奉進(jìn)行干預(yù),并觀(guān)察其治療效果。動(dòng)脈血?dú)夥治鲲@示大鼠在煙熏處理后即出現(xiàn)低氧血癥,PaO2降低,PaCO2升高,L﹑E﹑P組吸入性肺損傷大鼠的PaO2水平均明顯升高,L組的PaCO2水平明顯降低(P<0.05)。MPO是中性粒細(xì)胞與單核細(xì)胞的標(biāo)志酶,其活性高低可反映組織中中性粒細(xì)胞的浸潤(rùn)情況[11]。本研究結(jié)果顯示,L、E、P組肺組織中MPO活性均顯著降低(P<0.05),表明依達(dá)拉奉及葛根素均能有效抑制中性粒細(xì)胞浸潤(rùn)及MPO的釋放,減輕肺組織損傷,從而起到保護(hù)作用。TNF-α被認(rèn)為是引起急性肺損傷最重要的細(xì)胞前炎性因子之一,來(lái)源于巨噬細(xì)胞,是一種多功能促炎因子,可激活NF-κB介導(dǎo)其他細(xì)胞因子(如IL-1、IL-6、IL-8)的合成與釋放,啟動(dòng)炎癥級(jí)聯(lián)反應(yīng)。TNF-α還能促進(jìn)中性粒細(xì)胞(PMN)的吞噬能力,促進(jìn)PMN脫顆粒和釋放溶酶體,增強(qiáng)PMN呼吸爆發(fā),產(chǎn)生過(guò)多的氧自由基[12],破壞肺血管內(nèi)皮細(xì)胞和肺上皮細(xì)胞,加速急性肺損傷的發(fā)展進(jìn)程。本研究結(jié)果顯示,依達(dá)拉奉和葛根素均可降低煙霧吸入致肺損傷大鼠血清的TNF-α水平(P<0.05),且聯(lián)合用藥比單獨(dú)用藥效果更顯著(P<0.05)。IL-6可促進(jìn)細(xì)胞間黏附分子1的表達(dá),并促進(jìn)淋巴細(xì)胞的分化和炎性激活,使炎性損傷反應(yīng)進(jìn)一步加強(qiáng)[13]。本研究結(jié)果顯示,依達(dá)拉奉和葛根素均可降低煙霧吸入致肺損傷大鼠血清IL-6水平(P<0.05),且聯(lián)合用藥比單獨(dú)用藥效果更顯著(P<0.05)。IL-10可減輕炎性介質(zhì)對(duì)肺組織的破壞作用,在肺組織中由T淋巴細(xì)胞、B淋巴細(xì)胞以及單核巨噬細(xì)胞合成和分泌,其主要功能是抑制IL-1β、IL-8、TNF-α等前炎性細(xì)胞因子的合成和分泌[14]。本研究結(jié)果顯示,依達(dá)拉奉和葛根素均可提高煙霧吸入致肺損傷大鼠血清IL-10水平(P<0.05),但聯(lián)合用藥效果增加不明顯。本研究肺組織病理切片觀(guān)察也顯示出與上述實(shí)驗(yàn)結(jié)果相同的結(jié)論。
綜上所述,本研究采用黑火藥發(fā)煙裝置構(gòu)建大鼠吸入性肺損傷模型,結(jié)果顯示依達(dá)拉奉和葛根素對(duì)其具有很好的治療作用,且二者聯(lián)合用藥比單獨(dú)用藥效果更佳,為依達(dá)拉奉和葛根素的臨床應(yīng)用提供了實(shí)驗(yàn)依據(jù)。
[1] Liu Q, Feng SH, Zhao YJ,et al. Protective effects of different agents on smoke inhalation injury in rats model[J]. Chin J Inj Repair Wound Heal (Electron Ed), 2008, 3(4): 433-438.[劉群,馮世海, 趙永健, 等. 不同藥物對(duì)煙霧吸入性損傷大鼠肺保護(hù)作用的研究[J]. 中華損傷與修復(fù)雜志, 2008, 3(4): 433-438.]
[2] Xue J, Feng JC. Progress in the research on neuroprotective effects of Edaravone in the central nervous system[J]. Clin Focus, 2008, 23(15): 1137-1139.[薛晶, 馮加純. 依達(dá)拉奉對(duì)中樞神經(jīng)系統(tǒng)疾病的保護(hù)作用及機(jī)制[J]. 臨床薈萃, 2008, 23(15): 1137-1139.]
[3] Pan HP, Yang JZ, Li LL,et al. Study the effect of puerarin on blood cell aggregation in blood-srasis model rats[J]. Chin J Mod Appl Pharm, 2005, 22(1): 22-24.[潘洪平, 楊嘉珍, 李呂力,等.葛根素對(duì)大鼠血瘀證模型血細(xì)胞聚集作用的研究[J]. 中國(guó)現(xiàn)代應(yīng)用藥學(xué)雜志, 2005, 22(1): 22-24.]
[4] Alcorta R. Smoke inhalation & acute cyanide poisoning. Hydrogen cyanide poisoning proves increasingly common in smoke inhalation victims[J]. JEMS, 2004, 29(8): 6-15.
[5] Woodson LC. Diagnosis and grading of inhalation injury[J]. J Burn Care Res, 2009, 30(1): 143-145.
[6] Hemmil? M, Hihki? M, Kasanen JP,et al.In vivoandin vitroevaluation of the acute toxicity, the genotoxicity, and the irritation potency of two hexachloroethane-based pyrotechnic smokes[J]. J Toxicol Environ Health A, 2007, 70(14): 1167-1181.
[7] Zhou M, Yao B, Yan SX,et al. Establishment of a rat model of inhalation lung injury induced by powder combustion[J]. Med J Chin PLA, 2005, 30(8): 734-737.[周敏, 姚斌, 嚴(yán)尚學(xué), 等. 爆炸及火藥燃燒致吸入性肺損傷大鼠實(shí)驗(yàn)?zāi)P偷慕J]. 解放軍醫(yī)學(xué)雜志, 2005, 30(8): 734-737.]
[8] Hu JP, Wang J. Discussions on a few problems in the research of the intraluminal thread occlusion model of focal cerebral ischemia in rats[J]. Chin J Comp Med, 2004, 14(2): 115-118.[胡建鵬, 王鍵. 線(xiàn)栓法大鼠局灶性腦缺血模型研究中的幾個(gè)問(wèn)題[J]. 中國(guó)比較醫(yī)學(xué)雜志, 2004, 14(2): 115-118.]
[9] Bury SD, Jones TA. Unilateral sensorimotor cortex lesions in adult rats facilitate motor skill learning with the "unaffected" forelimb and training induced dendritic structural plasticity in the motor cortex[J]. J Neurosci, 2002, 22(19): 8597-8606.
[10] Liu YF, Tang HW, Wu XL,et al. Reproduction and evaluation of a rat model of inhalation lung injury caused by black gunpowder smog[J]. Med J Chin PLA, 2013, 38(8): 670-674. [劉一凡, 唐紅衛(wèi), 吳小利, 等. 黑火藥煙霧致吸入性肺損傷大鼠模型的建立與評(píng)價(jià)[J]. 解放軍醫(yī)學(xué)雜志, 2013, 38(8): 670-674.]
[11] Enkhbaatar P, Traber DL. Pathophysiology of acute lung injury in combined burn and smoke inhalation injury[J]. Clin Sci, 2004, 107(2): 131-143.
[12] Delong WG, Born CT. Cytokines in patients with polytrauma[J]. Clin Orthop Relat Res, 2004, 5(422): 57-65.
[13] Granger J, Remick D. Acute pancreatitis: models, markers, and mediators[J]. Shock, 2005, 24 Suppl 1: 45-51.
[14] Enkhbaatar P, Wang J, Saunders F,et al. Mechanistic aspects of inducible nitric oxide synthase-induced lung injury in burn trauma[J]. Burns, 2011, 37(4): 638-645.
Effects of puerarin combined with edaravone on inhalation lung injury induced by black gunpowder smog in rats
WANG Zheng-guan1, LI Rui-bing1, XU Shu-min1, GUO Yu-ni1, CHEN Wen-yan1, CHEN Yi-hong2*, WANG Cheng-bin1*1Department of Clinical Laboratory,2Department of Medical Security, General Hospital of PLA, Beijing 100853, China
*Corresponding author. CHEN Yi-hong, E-mail: 9578cyh@sina.com; WANG Cheng-bin, E-mail: wangcb301@126.com
This work was supported by the “Twelfth Five-Year Plan” Medical Science Development Foundation of PLA (CWS12J021)
ObjectiveTo explore the protective effects of puerarin combined with edaravone on inhalation lung injury induced by black gunpowder smog in rats.MethodsForty healthy male Wistar rats were randomly divided into normal control group (group N), inhalation group (group X), puerarin group (group P), edaravone group (group E) and edaravone combined with puerarin group (group L), with 8 rats in each group. Rat model of inhalation lung injury was reproduced by a self-made smoke generator. Rats in group E were given intraperitoneal injections of edaravone (9 mg/kg) at 30 minutes and 1 day after modeling (twice totally). Rats in group P were given intraperitoneal injections of puerarin (100 mg/kg) at 30 minutes and 1, 2, 3, 4, 5 days after modeling (6 times totally). Rats in group L were treated the way of both group E and P. The rats in group N and group X were given intraperitoneal injections of normal saline (12 ml/kg) at the time-points above. The animals were sacrificed 6 days after modeling, and the blood samples were collected from abdominal aorta to assess arterial blood gas values, meanwhile the serum levels of tumor necrosis factor-α (TNF-α), interleukin-6 (IL-6), interleukin-10 (IL-10) were determined by ELISA. Lung tissue homogenates were prepared to determine the protein content and myeloperoxidase (MPO) activity. The pathological changes in the lung tissue with HEstaining were observed under light microscope.ResultsArterial blood gas analysis revealed that the PaO2levels in groups P, E and L were higher than that in group X (P<0.05), and the PaO2levels in groups E and L were higher than that in group P (P<0.05), while the PaCO2level in group L was lower than that in groups X and E (P<0.05). The TNF-α, IL-6 and IL-10 levels in serum, the protein content and MPO activity in lung tissue homogenate in groups P, E and L were lower than those of group X (P<0.05). The TNF-α and IL-6 levels in serum and protein content and MPO activity in lung tissue homogenate in groups E and L were lower than those of group P (P<0.05), while IL-10 level in serum was higher than that of group P (P<0.05). The TNF-α and IL-6 levels in serum and protein content in lung tissue homogenate in group L were lower than those of group E (P<0.05). HE staining revealed that lung edema was alleviated and inflammatory exudate and infiltration in groups P, E and L were less marked when compared with group X, while they were more significant in group L.ConclusionsEdaravone combined with puerarin can alleviate the inflammatory reaction of inhalation lung injury induced by black gunpowder smogviareducing the production and release of pro-inflammatory mediators, thus playing a protective role against lung injury. The effect of a combination of the drugs is better than that of either drug alone.
edaravone; puerarin; pneumonia, aspiration
R563.19
A
0577-7402(2015)01-0066-05
10.11855/j.issn.0577-7402.2015.01.15
2014-09-12;
2014-12-01)
(責(zé)任編輯:胡全兵)
全軍“十二五”醫(yī)學(xué)科研基金面上項(xiàng)目(CWS12J021)
王正冠,碩士研究生。主要從事戰(zhàn)時(shí)煙霧吸入致肺損傷的炎癥反應(yīng)機(jī)制及藥理防治研究
100853 北京 解放軍總醫(yī)院臨床檢驗(yàn)科(王正冠﹑李芮冰﹑徐舒敏﹑郭宇妮﹑陳文燕﹑王成彬),醫(yī)學(xué)保障部(陳宜鴻)
]陳宜鴻,E-mail:9578cyh@ sina.com;王成彬,E-mail:wangcb301@126.com