气管切开插管大鼠肺部形态学和肥大细胞活性的动态变化及其意义

doi:10.13481/j.1671-587x.20190209

摘要/Abstract

摘要： 目的：探讨气管切开插管后大鼠肺部形态学和肥大细胞活性动态变化及其意义，阐明气管切开插管大鼠肺部炎症发生的机制。方法：48只SPF级健康雄性SD大鼠随机分为正常对照组和气管切开插管组，每组24只。制作大鼠气管切开插管留置模型，在造模成功后分别于24、48、72和168h 4个时间点处死大鼠，取肺组织和肺泡灌洗液，光学显微镜下观察肺组织病理变化，透射电镜观察2组大鼠肥大细胞的超微结构，ELISA法测定2组大鼠肺泡灌洗液中组胺、肿瘤坏死因子α（TNF-α）和白细胞介素6（IL-6）水平，免疫组织化学法测定2组大鼠肺组织中类胰蛋白酶β表达水平。结果：光镜下气管切开插管组大鼠肺组织于各个时间点均有不同程度的炎症等改变，Smith评分均高于正常对照组（P<0.05）；气管切开插管组内不同时间点比较，随着时间的延长，大鼠肺组织炎症等变化不断加重，Smith评分升高（P<0.05）。气管切开插管组大鼠各时间点肥大细胞出现不同程度的脱颗粒，其中以24 h脱颗粒最明显。气管切开插管组大鼠肺泡灌洗液中组胺水平在24、72和168 h 3个时间点高于正常对照组（P<0.05），在48h时2组组胺水平比较差异无统计学意义（P>0.05）。气管切开插管组大鼠肺泡灌洗液中TNF-α和IL-6水平在不同时间点均明显高于正常对照组（P<0.05），在24 h时达到峰值，随后下降（P<0.05）。气管切开插管组大鼠肺组织中类胰蛋白酶β表达水平在不同时间点均明显高于正常对照组（P<0.05），在24 h时达到最高峰（P<0.05）。结论：气管切开后大鼠肺部肥大细胞活性明显增强，肥大细胞活性增强可能是气管切开大鼠肺部炎症发生的主要机制之一。

关键词: 气管切开插管, 肥大细胞, 炎症, SD大鼠

Abstract: Objective: To investigate the dynamic changes of pulmonary morphology and mast cell activity in the rats after tracheotomy and intubation and their significances, and to elucidate the mechanism of occurrence of pulmonary inflammation in the rats after tracheotomy and intubation.Methods: A total of 48 SPF female SD rats were randomly divided into normal control group and tracheotomy and intubation group (n=24).The lung tissue and alveolar lavage fluid of the rats were collected at 24, 48, 72 and 168 h after modeling, respectively. The pathological changes of lung tissue of the rats were observed by light microscope. Transmission electron microscope was used to observe the mast cell ultrastructures of the rats. The levels of histamine, TNF-α and IL-6 in alveolar lavage fluid of the rats in two groups were measured by ELISA. The expression levels of β-tryptase in lung tissue of the rats in two groups were measured by immunohistochemical method.Results: The different levels of inflammation of lung tissue of the rats were found in tracheotomy and intubation group under light micscope and the Smith scores were higher than those in control group(P<0.05);the damage in tracheotomy and intubation group was aggravated with the prolongation of time, and the Smith scores were increased, there were significant differences between different time points (P<0.05).The mast cell degranulation at different levels of the rats in tracheotomy and intubation group were found at different time points, especially at 24 h. The histamine levels in alveolar lavage fluid of the rats in tracheotomy and intubation group at 24,72,and 168 h were higher than those in normal control group(P<0.05);there was no significant difference in the histamine levels at 48 h between two groups(P>0.05). The levels of TNF-a and IL-6 in alveolar lavage fluid of the rats in tracheotomy and intubation group at different time points were higher than those in normal control group (P<0.05);they reached a peak at 24 h and then declined(P<0.05).The expression levels of mast cell β-tryptase in the lung tissue of the rats in tracheotomy and intubation group at different time points were higher than those in normal control group(P<0.05), and reached a peak at 24 h(P<0.05).Conclusion: The lung mast cell activity is enhanced obviously after tracheotomy and intubation. It may be one of the main mechanisms of complicated pneumonia of the rats with tracheotomy and intubation.

Key words: tracheotomy and intubation, mast cells, inflammation, SD rats

中图分类号:

R459.7

王学敏, 邓淑蓉, 彭玲玲, 潘茂华, 潘宇政. 气管切开插管大鼠肺部形态学和肥大细胞活性的动态变化及其意义[J]. 吉林大学学报(医学版), 2019, 45(02): 262-267.

WANG Xuemin, DENG Shurong, PENG Lingling, PAN Maohua, PAN Yuzheng. Dynamic changes of pulmonary morphology and mast cell activity in rats after tracheotomy and intubation and their significances[J]. Journal of Jilin University(Medicine Edition), 2019, 45(02): 262-267.

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