转化生长因子-β1在体外循环后肺组织表达及N-乙酰半胱氨酸干预.DOCVIP

临床医学论文-转化生长因子-β1在体外循环后肺组织表达及N-乙酰半胱氨酸干预 【摘要】? 目的 观察转化生长因子-β1(TGF-β1)在犬体外循环(CPB)后肺组织的表达及N-乙酰半胱氨酸(NAC)对其表达的影响。方法 建立成年犬CPB相关肺损伤模型，随机分为三组，每组8例。C组(CPB中用生理盐水)，N1组(CPB前用NAC)，N2组(CPB中用NAC)。通过监测5个不同时段，即CPB)前(T0)、CPB中30 min(T1)、停机后15 min(T2)、30 min(T3)和60 min(T4)时间点取肺组织标本，检测肺组织TGF-β1的表达及髓过氧化物酶(MPO)活性，同时于T0、T3、T4时间点抽取动脉血测定呼吸指数(RI)。结果 T0时三组RI差异无统计学意义(P0.05)，与C组比较，N1组、N2组T3、T4时的RI升高幅度低(P0.05)，且N1组低于N2组(P0.05);T0时三组肺组织中MPO活性差异无统计学意义(P0.05)， 在T2、T3、T4时，N1组、N2组肺组织中MPO活性低于C组(P0.05);T0时三组肺组织中偶见TGF-β1表达，随CPB时间的延长，TGF-β1表达均增强，且N1组弱于N2组、C组(P0.05)。结论 CPB可使肺组织TGF-β1表达明显增强，NAC能抑制肺组织TGF-β1的表达，改善RI，减轻肺损伤;且保护效果CPB前NAC的优于CPB中用NAC。 【关键词】? 转化生长因子-β1;N-乙酰半胱氨酸;体外循环;肺;损伤;犬 　　Abstract: OBJECTIVE To observe in expression of TGF-β1 in lung tissues of acute lung injury dog model induced by cardiopulmonary bypass (CPB) and the effect of N-acetylcysteine (NAC) on its expression. METHODS Twenty-four adult health dogs, were randomly divided into three groups:groupC(received normal saline after CPB), groupN1 (receive NAC given intravenously before CPB started), group N2 (receive NAC aftere CPB started). Lung tissue samples were collected before CPB(T0), at 30min after start of CPB(T1), 15min (T2), 30 min (T3), 60 min (T4) after end of CPB in all groups. The expression of TGF-β1, myeloperoxidase (MPO) of lung tissue was detected at above mentioned time points. Histology of lung under microscope in 3 groups were examined. Blood samples were collected from femoral artery for monitoring respiratory index(RI)at T0,T2, T3. RESULTS No significant differences were found in the levels of RI in all three groups atT0. However, at T3,T4, the RI significantly higher in group c than in group N1, N2(P0.05) and significantly lower in group N1 than in group N2(P0.05); No significant differences were found in the level of MPO activity in the three groups at T0. MPO activity were significantly lower in group N1, N2 than those in group C at T2, T3,T4(P0.05); The expression of TGF-β1 was occasionally detected at T0(P0.05), they