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目的 研究乙酰半胱氨酸联合地塞米松对氯气引起的急性肺损伤的保护作用.方法 将60只小鼠随机分为5组,每组12只.模型组、地塞米松(3 mg·kg-1)组、乙酰半胱氨酸(40 mg· kg-1)组及联合治疗(地塞米松3 mg·kg-1+乙酰半胱氨酸40 mg ·kg-1)组小鼠给予2.536 g·m-3的氯气动态染毒,染毒时间为20 min,对照组给予空气处理.建模成功后给予地塞米松组、乙酰半胱氨酸组及联合治疗组小鼠相应的药物处理,对照组和模型组给予等体积生理盐水,6h后检测各组小鼠肺组织湿干重比和病理学、支气管肺泡灌洗液中蛋白水平和白细胞计数、肺组织MDA含量.结果 与对照组相比,模型组小鼠肺组织损伤明显,肺组织损伤评分和湿干重比、支气管肺泡灌洗液中蛋白水平和白细胞计数、肺组织MDA含量均升高(P＜0.05).与模型组相比,地塞米松组、乙酰半胱氨酸组和联合治疗组小鼠肺组织损伤改善,肺组织损伤评分和湿干重比、支气管肺泡灌洗液中蛋白水平和白细胞计数、肺组织MDA含量均降低(P＜0.05);联合治疗组与地塞米松组和乙酰半胱氨酸组相比,以上指标降低更明显(P＜0.05).结论 对于氯气引起的小鼠急性肺损伤,乙酰半胱氨酸联合地塞米松治疗效果优于单药治疗.“,”AIM To study the protective effects of acetylcysteine combined with dexamethasone on acute lung injury caused by chlorine.METHODS Sixty mice were randomly divided into 5 groups with 12 mice in each group.Mice in the model group,the dexamethasone (3 mg·kg-1) group,the acetylcysteine (40 mg·kg-1) group and the combined treatment group (dexamethasone 3 mg·kg-1 + acetylcysteine 40 mg·kg-1) group were given dynamic exposure with 2.536 g·m-3 of chlorine,and the time for exposure was 20 minutes.Mice in the control group were given air.Mice in the dexamethasone group,the acetylcysteine group and the combined treatment group were treated with corresponding drugs after successful modeling while mice in the control group and the model group were treated with the equal volume of normal saline.Six hours later,the wet to dry weight ratio and pathology of lung tissues,the protein level and white blood cell count in bronchoalveolar lavage fluid,and MDA levels in lung tissues of all group were detected.RESULTS Compared with the control group,the lung tissue injury was more obvious,and the lung tissues injury score,the wet to dry weight ratio,the protein level and white blood cell count in bronchoalveolar lavage fluid,MDA levels in lung tissues were higher in the model group (P ＜ 0.05).Compared with the model group,the lung tissue injuries were milder,and the lung tissues injury score,the wet to dry weight ratio,the protein level and white blood cell count in bronchoalveolar lavage fluid,and MDA levels in lung tissues were lower in the dexamethasone group,the acetylcysteine group and the combined treatment group (P ＜ 0.05).The decrease of above-mentioned indexes in the combined treatment group was more obvious than that in the dexamethasone group and acetylcysteine group (P ＜ 0.05).CONCLUSION The effect of acetylcysteine combined with dexamethasone is better than that of monotherapy in the treatment of mice with acute lung injury caused by chlorine.