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目的 :探讨肺脏氧化 -还原状态与肺脏炎症、肺纤维化的关系及N 乙酰半胱氨酸对肺纤维化的影响。方法 :健康雌性Wistar大白鼠经支气管灌注博莱霉素 (BLM )造成肺间质纤维化。部分灌注BLM后每日腹腔注射N 乙酰半胱氨酸 (NAC) 4 0mg/kg。计数支气管肺泡灌洗液 (BALF)中细胞总分数 ,检测血清和BALF中谷胱甘肽(GSH)、丙二醛 (MDA)的含量。肺组织制成石蜡切片行HE染色进行病理和炎症积分分析。左肺匀浆后测羟脯氨酸 (HYP)含量。结果 :BLM组急性炎症期BALF细胞总数显著增高 ,中性粒细胞 (PMN)、淋巴细胞百分比显著增高 ,肺组织炎症积分增加 ,14d时HYP含量较对照组显著增加 (P <0 .0 5 ) ;NAC能够降低急性期BALF中细胞总数、PMN和淋巴细胞百分比 ,但在纤维化期细胞总数有所增加。NAC组肺组织炎症积分下降 ,但HYP含量较BLM组略增加 ;各组血清GSH和MDA水平无显著差异 ;BLM组BALFGSH水平第 17天显著降低 ,NAC能够显著提高BALFGSH水平。结论 :BALFGSH ,MDA水平较血清GSH ,MDA水平能更好的反映肺脏损伤情况和对治疗的反应 ;NAC(40mg/kg)能够减少肺组织炎症细胞的浸润和BALF中中性粒细胞百分比 ,表明小剂量NAC具有一定的抗炎作用 ,但其对肺纤维化大鼠胶原沉积无保护作用。
Objective: To investigate the relationship between lung oxidation-reduction status and lung inflammation, pulmonary fibrosis and N-acetylcysteine on pulmonary fibrosis. Methods: Pulmonary interstitial fibrosis was induced by bronchial injections of bleomycin (BLM) in healthy female Wistar rats. After partial perfusion BLM daily intraperitoneal injection of N-acetyl cysteine (NAC) 40mg / kg. The total cell number in bronchoalveolar lavage fluid (BALF) was counted and the levels of glutathione (GSH) and malondialdehyde (MDA) in serum and BALF were measured. Paraffin sections of lung tissue were stained with HE for pathological and inflammatory integral analysis. Left lung homogenate after hydroxyproline (HYP) content. Results: The total number of BALF cells in BLM group was significantly increased, the percentage of neutrophils (PMN) and lymphocytes was significantly increased, the inflammation score of lung tissue increased, and the content of HYP in 14th day was significantly higher than that in control group (P <0.05) NAC decreased the total number of cells, PMN and lymphocyte in BALF in acute phase, but increased the total number of cells in fibrosis phase. Inflammatory scores in lung tissue of NAC group decreased, but the content of HYP increased slightly compared with that of BLM group. There was no significant difference of GSH and MDA levels in each group. BALFGSH level in BLM group decreased significantly on the 17th day and NAC increased BALFGSH level significantly. CONCLUSIONS: Compared with serum GSH and MDA levels, BALFGSH and MDA levels can better reflect lung injury and response to treatment. NAC (40mg / kg) can reduce infiltration of inflammatory cells and percentage of neutrophils in BALF, indicating that Small doses of NAC has a certain anti-inflammatory effect, but it has no protective effect on collagen deposition in rats with pulmonary fibrosis.