卡托普利在通气相关肺损伤大鼠模型中的保护作用-第三军医大学学报.DOCVIP

卡托普利在通气相关肺损伤大鼠模型中的保护作用 钟贞1 张婷2（1重庆市中山医院感染科， 重庆400013， 2重庆医科大学附属第二医院呼吸科内科，重庆400011） 摘要：目的：探讨通气相关肺损伤（VILI）中的肺部炎症反应和肺内血管紧张素II的关系并研究血管紧张素转换酶抑制剂（卡托普利）在大鼠通气相关肺损伤模型中的作用。方法： 将21只雄性SD大鼠随机分成三组：1）高潮气量，零呼气末正压（HVZP）组；2）卡托普利治疗组（HVZP+CAP）组；3）空白对照组。行动脉插管和气管插管后行动脉血气分析和平均动脉压的测定，同时测定支气管肺泡灌洗液中的总蛋白数和巨噬细胞炎性蛋白-2（MIP-2）的浓度及肺组织血管紧张素II的水平，并观察肺组织形态学的变化。结果：在HVZP+CAP组中，大鼠的平均动脉压明显低于HVZP组。在HVZP组中，大鼠肺泡灌洗液中的总蛋白水平明显高于对照组，且灌洗液中的巨噬细胞炎性蛋白-2和肺血管紧张素II明显高于对照组和HVZP+CAP组。肺血管紧张素II的水平是和肺泡灌洗液中的蛋白水平和巨噬细胞炎性蛋白-2的水平呈正相关。结论：卡托普利通过下调炎症因子可以降低机械通气中肺损伤的程度，机械通气相关肺损伤是和肺部的血管紧张素系统有关。 关键词：机械通气相关肺损伤；卡托普利；支气管肺泡灌洗液；巨噬细胞炎性蛋白；血管紧张素II。 Angiotensin-converting enzyme inhibitor captopril attenuates ventilator-induced lung injury in rats Abstract: Objective To study the relationship between lung flammation and lung angiotensin II(ANGII) in ventilator-induced lung injury (VILI) and assessed the ability of the angiotensin-converting enzyme inhibitor captopril to attenuate VILI in rats. Methods: 21 adult male Sprague-Dawley rats were randomly assigned into three groups:1) high-volume, 0 positive end-expiratory pressure (HVZP) group, 2) injection of captopril (100 mg/kg ip) 30min before HVZP ventilation (HVZP+CAP group). 3) this group did not receive ventilation and it is served as the control. The blood gas tensions and mean arterial pressure were measured after a polyethylene catheter was placed in one carotid artery and a plastic cannula was inserted into the trachea.The protein contents and macrophage inflammatory protein-2 in bronchoalveolar lavage fluid (BALF) and lung ANGII were determined The changes of lung pathology were observed. Results: Mean arterial pressure was significantly lower in the HVZP+CAP group than in the HVZP group at 2h of ventilation. Total protein levels were significantly higher in bronchoalveolar lavage fluid(BALF) recovered from HVZP-ventilated rats than from controls. BALF macrophage inflammatory protein-2 and lung ANG II were significantly higher in the HVZP group than in the control and HVZP+CAP gr