小剂量氢化可的松与血必净对急性肺损伤大鼠作用比较

doi:10.3877/cma.j.issn.1674-0785.2017.11.006

目的

观察小剂量氢化可的松与血必净注射液对大肠埃希菌导致的大鼠急性肺损伤（ALI）的保护作用。

方法

大肠埃希菌[O₁₁₁B₄，（4.4~5.6）×10¹²CFU/L]3 ml/kg气管注射制作大鼠肺内源性ALI模型，设氢化可的松干预组[HC组，腹腔注射氢化可的松5 mg/（kg?d），共2天]、血必净干预组[X组，腹腔注射血必净注射液5 ml/（kg?d），共2 d]、模型对照组[C组，腹腔注射生理盐水5 ml/（kg?d），共2天]、正常对照组[N组，气管注射3 ml/（kg?d）生理盐水，腹腔注射生理盐水5 ml/（kg?d），共2天]。各组分别于末次给药后12 h放血处死动物，留血清测TNF-α、IL-8水平。取左肺计算肺指数。

结果

（1）HC组、X组、C组病死率无统计学意义（χ²=0.194，P=1.000）；（2）TNF-α水平：HC组及X组[分别为（80.31±11.87）ng/L，（89.42±22.76）ng/L]均明显低于C组[（125.68±27.91）ng/L]（P<0.05），HC组与X组差别无统计学意义（P>0.05）；（3）IL-8水平：HC组与X组[分别为（175.01±40.29）ng/L，（214.38±56.03）ng/L]均明显低于C组[（266.48± 56.09）ng/L]（P<0.05），HC组与X组差别无统计学意义（P>0.05）；（4）肺指数：HC组与X组[分别为（0.318±0.058）%，（0.352±0.046）%]均明显低于C组[（0.412±0.055）%]（P<0.05），HC组与X组差别无统计学意义（P>0.05）。

结论

小剂量氢化可的松及血必净治疗大肠杆菌导致的大鼠ALI均能明显降低血清促炎因子的水平，减轻肺水肿，两者作用相似。

关键词: 急性肺损伤, 氢化可的松, 血必净注射液, 细胞因子, 大鼠

Objective

To investigate the efficacy of low-dose hydrocortisone and Xuebijing injection on acute lung injury (ALI) induced by Escherichia coli (E.coli) in rats.

Methods

ALI model was induced in Wistar rats by intratracheal E.coli injection [3 ml/kg, O₁₁₁B₄, (4.4~5.6)×10¹²CFU/L], twelve hours later the survived rats were randomly divided into hydrocortisone group (HC) treated with hydrocortisone for two days [5 mg/(kg?d), intraperitoneally], Xuebijing group (X) treated with Xuebijing injection for two days [5 ml/(kg?d), intraperitoneally], and ALI control group (C) treated with normal saline for two days (5 ml/(kg?d), intraperitoneally). And there was a normal control group (N) that received intratracheal E.coli (3 ml/kg) injection and was treated with intraperitoneal normal saline for two days [5 ml/(kg?d)]. Twelve hours after the treatment the rats were killed, and the levels of TNF- and IL-8 in serum were measured by ELASA, then the lung index was calculated.

Results

There was no difference in mortality among group HC, X and C (χ²=0.194, P=1.000). The levels of TNF- in serum in group HC and X [(80.31±11.87) ng/L and (89.42±22.76) ng/L, respectively] were significantly lower than that in group C [(125.68±27.91) ng/L] (P<0.05), but there was no significant difference between group HC and X (P>0.05); IL-8 in group HC and X [(175.01±40.29) ng/L and (214.38±56.03) ng/L, respectively] were significantly lower than that in group C [(266.48±56.09) ng/L] (P<0.05), but there was no significant difference between group HC and X (P>0.05); The lung index in group HC and X [(0.318±0.058)% and (0.352±0.046)%, respectively] were significantly lower than that in group C [(0.412±0.055)%] (P<0.05), but there was no significant difference between group HC and X (P>0.05).

Conclusion

Both low-dose hydrocortisone and Xuebijing injection can inhibit the production of pro-inflammatory cytokines and attenuate pulmonary edema in rats with E.coli-induced ALI with similar effects.

Key words: Acute lung injury, Hydrocortisone, Xuebijing injection, Cytokine, Rat

表1 血清中TNF-α、IL-8及肺指数的变化（±s）

组别	开始例数	存活例数	TNF-α（ng/L）	IL-8（ng/L）	肺指数（%）
HC组	13	9	80.31±11.87^ab	175.01±40.29^ab	0.318±0.058^ab
X组	14	10	89.42±22.76^ab	214.38±56.03^ab	0.352±0.046^ab
C组	12	8	125.68±27.91^a	266.48±56.09^a	0.412±0.055^a
N组	8	8	41.04±16.43	63.29±19.21	0.170±0.023
F值			22.88	28.364	38.391
P值			<0.001	<0.001	<0.001

表1 血清中TNF-α、IL-8及肺指数的变化（±s）

组别	开始例数	存活例数	TNF-α（ng/L）	IL-8（ng/L）	肺指数（%）
HC组	13	9	80.31±11.87^ab	175.01±40.29^ab	0.318±0.058^ab
X组	14	10	89.42±22.76^ab	214.38±56.03^ab	0.352±0.046^ab
C组	12	8	125.68±27.91^a	266.48±56.09^a	0.412±0.055^a
N组	8	8	41.04±16.43	63.29±19.21	0.170±0.023
F值			22.88	28.364	38.391
P值			<0.001	<0.001	<0.001

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Comparison of the effects of low-dose hydrocortisone and Xuebijing injection on acute lung injury in rats

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Comparison of the effects of low-dose hydrocortisone and Xuebijing injection on acute lung injury in rats