严重胸部创伤对肺泡巨噬细胞免疫功能的影响-第三军医大学学报.DOC

急性肺损伤对肺间质巨噬细胞免疫功能的影响 张伟1、蒋耀光2、谢志坚3、张宇3、胡承香3，李磊3 （1.第三军医大学西南医院胸心外科，重庆400038；2.第三军医大学大坪医院胸心外科；3.第三军医大学大坪医院野战外科研究所） 摘要：目的：观察急性肺损伤后肺间质巨噬细胞免疫功能的变化，并探讨其意义。方法：建立严重胸部创伤模型，支气管肺泡灌洗分离、培养肺泡间质巨噬细胞，检测创伤前、创伤后2、4、8、16、24小时以及复合LPS攻击后肺间质巨噬细胞吞噬功能、细胞因子分泌等免疫功能的变化。结果：利用小型多功能生物撞击机以400Kpa驱动压力对大鼠右侧上胸壁进行致伤，能够建立稳定可靠并符合临床特点的严重胸部创伤模型；严重胸部创伤对肺间质巨噬细胞的吞噬功能表现为先增强后抑制；而分泌细胞因子TNF-α及IL-6增强，伤后4h达到高峰。结论：急性肺损伤导致肺间质巨噬细胞免疫功能紊乱，本研究为创伤性急性肺损伤的发病机制提供了一定的实验及理论依据。 关键词：急性肺损伤，肺间质巨噬细胞，免疫功能，脂多糖 Changes of immune function on interstitial macrophages after acute lung injury ZHANG wei*,JIANG yao-guang,XIE zhi-jian,LV feng-lin,HU cheng-xiang,LI lei *Department of Thoracic Surgery,South-West Hospital, Third Military Medical University,Chongqing 400038,China Corresponding author:LI Lei. First Department,Research Institute of Surgery,Da Ping Hospital,Third Military Medical University,Chongqing 400042,China [Abstract] Objective To observe the changes of immune function of interstitial macrophages. Methods A rat model of severe thoracic trauma was established, interstitial macrophages were collected by the bronchoalveolar lavage fluid,and separated and cultured. And changes of the phagocytosis, angtigen presentation and secretion of IM after trauma were observed dynamically at 2,4,8,16,24h after trauma,. Results A stable and reliable severe thoracic trauma model was successfully established with 400Kpa-strike on the up-right chest of rat by a multiple-function strike apparatus. The phagocytosis of interstitial macrophages had a biphasic effects, firstly enhanced then inhibited;reversely, interstitial macrophages secreted more TNF-α and IL-6 after trauma.Conclusion Immune function disorder was induced by severe thoracic trauma. The present study presented the valuable laboratorial and theoretical evidence for the research on ALI complicated with severe thoracic trauma. Key words: thoracic trauma; interstitial macrophages; immune function; LPS; acute lung injury 急性肺损伤（ALI）是严重胸部创伤的主要并发症，由于机体免疫功能紊乱而导致的抵抗力下降引起的肺部感染是其最常见的原