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目的观察预先使用盐酸氨溴索(沐舒坦)对盐酸吸入性肺损伤是否具有保护作用,并探讨其可能机制。方法将24只大鼠随机等分为3组:生理盐水吸入组(A 组);稀盐酸吸入组(B 组);稀盐酸吸入+沐舒坦处理组(C 组)。C 组予以50mg/kg 沐舒坦腹腔注射,1次/d,连续3 d,A、B 组则以等容积生理盐水腹腔注射代替。第3天腹腔注射沐舒坦或生理盐水30 min后,A 组以1.2 mg/kg 生理盐水经气管注入制作假盐酸吸入肺损伤作模型为对照;B,C 组则用 HCl+生理盐水配制成 pH 值为1.25的混合液以1.2 mg/kg 气管注入制成盐酸吸入肺损伤模型。观察盐酸注入5 h 后大鼠动脉血气,肺组织匀浆和血清中 TNFα、IL-8的含量。结果盐酸吸入后5 h PaO_2明显下降,而沐舒坦预先处理后能抑制 PaO_2的下降程度,3组间比较均有显著性差异(P<0.01)。盐酸吸入5 h 后肺组织匀浆中 TNFα和 IL-8值的影响,3组间两两比较差异均有显著性(P<0.05和 P<0.01)。盐酸吸入后可引起血中 IL-8明显升高,而沐舒坦能抑制 IL-8升高,3组间比较差异有显著性(P<0.01)。盐酸吸入可引起 TNFα轻度上升,但3组间比较差异无显著性(P>0.05)。结论稀盐酸吸入可造成血氧分压下降,盐酸氨溴索可能通过抑制 TNFα、IL-8炎症因子的产生和释放机制来改善氧合,对盐酸吸入性肺损伤有保护作用。
Objective To observe whether pre-use of ambroxol hydrochloride (Mucosolvan) has a protective effect on inhaled lung injury induced by hydrochloric acid and to explore its possible mechanism. Methods Twenty-four rats were randomly divided into three groups: saline inhalation group (group A), dilute hydrochloric acid inhalation group (group B), diluted hydrochloric acid inhalation and ambroxol treatment group (group C). Group C was treated with 50 mg / kg of mucosolvan by intraperitoneal injection once a day for 3 consecutive days. Groups A and B received intraperitoneal injection of normal saline instead of intraperitoneal injection. The rats in group A were injected with 1.2 mg / kg normal saline via trachea to make fake hydrochloric acid inhalation lung injury model for control on the 3rd day after intraperitoneal injection of mucosolvan or saline for 30 min. Groups B and C were treated with HCl + saline to make pH value 1.25 mixture of 1.2 mg / kg tracheal injection of hydrochloric acid into the lung injury model. The contents of TNFα and IL-8 in arterial blood gas, lung homogenates and serum were observed after 5 h injection of hydrochloric acid. Results PaO2 was significantly decreased 5 h after inhalation of hydrochloric acid, and the pretreatment of mucosolvan could inhibit the decline of PaO 2, there were significant differences among the three groups (P <0.01). The levels of TNFα and IL-8 in lung homogenate after 5-h inhalation of hydrochloric acid were significantly different between the three groups (P <0.05 and P <0.01). Hydrochloric acid inhaled can cause a significant increase in blood IL-8, while Mucosolvan can inhibit IL-8 increased, the difference between the three groups was significant (P <0.01). Hydrochloride inhalation can cause TNFα slightly increased, but no significant difference between the three groups (P> 0.05). Conclusions Inhalation of dilute hydrochloric acid can cause the decrease of partial pressure of blood oxygen. Ambroxol hydrochloride may improve oxygenation by inhibiting the production and release mechanism of TNFα and IL-8 inflammatory factors, and may have protective effects on inhaled lung injury induced by hydrochloric acid.