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目的探讨比例辅助通气(PAV)对胎粪吸入幼兔肺组织中肿瘤坏死因子-α(TNF-α)和白细胞介素-8(IL-8)水平的影响。方法将30只日龄20～30天的幼兔随机分为灌入胎粪后实施PAV组和灌入胎粪后实施同步间歇指令通气(SIMV)组,并与胎粪吸入不予通气组(MAS组)及灌生理盐水组(对照组)进行比较,各组分别于8h后处死,ELISA法检测肺组织匀浆及肺泡灌洗液中TNF-α、IL-8的含量。结果 (1)肺组织湿干比PAV组(7.81±0.52)、SIMV组(8.79±0.96)、MAS组(7.12±0.74)均高于对照组(4.22±0.30),SIMV组高于PAV组和MAS组,差异有统计学意义(P均<0.05);PAV组与MAS组差异无统计学意义(P>0.05)。(2)PAV组、SIMV组和MAS组肺组织匀浆TNF-α含量(pg/ml)[(872.6±104.0)、(973.9±114.5)和(707.1±39.1)]及IL-8含量(pg/ml)[(787.0±89.3)、(872.9±87.0)和(641.4±60.3)]均高于对照组[(401.1±74.5)和(381.3±63.3)],SIMV组高于PAV组和MAS组,PAV组高于MAS组,差异有统计学意义(P均<0.05)。(3)PAV组、SIMV组及MAS组肺泡灌洗液TNF-a含量[(644.4±89.3)、(787.1±100.6)和(536.0±28.5)]均高于对照组(301.8±75.9),SIMV组高于PAV组,差异有统计学意义(P均<0.05);PAV组、SIMV组及MAS组IL-8含量[(653.0±93.3)、(744.7±81.8)和(532.4±60.1)]均高于对照组(280.9±70.8),SIMV组高于PAV组和MAS组,PAV组高于MAS组,差异有统计学意义(P均<0.05)。结论胎粪在炎症反应中可促进TNF-α、IL-8释放,PAV治疗MAS时所致肺损伤程度较SIMV小。
Objective To investigate the effects of proportion assisted ventilation (PAV) on the levels of tumor necrosis factor-α (TNF-α) and interleukin-8 (IL-8) Methods Thirty rabbits of 20-30 days old were randomly divided into two groups: the rabbits in each group were injected with meconium and then injected with meconium to infuse meconium. Simultaneous intermittent inspiratory ventilation (SIMV) group and meconium aspiration group MAS group) and normal saline group (control group). The rats in each group were sacrificed at 8h and the contents of TNF-α and IL-8 in lung homogenate and BALF were detected by ELISA. Results Compared with PAV group (7.81 ± 0.52), SIMV group (8.79 ± 0.96) and MAS group (7.12 ± 0.74), the wet and dry lung tissue were significantly higher than those in control group (4.22 ± 0.30) MAS group, the difference was statistically significant (P <0.05). There was no significant difference between PAV group and MAS group (P> 0.05). (2) TNF-αcontent (pg / ml) [(872.6 ± 104.0), (973.9 ± 114.5) and (707.1 ± 39.1)] and IL-8content in lung tissue of PAV, SIMV and MAS groups / ml) (787.0 ± 89.3), (872.9 ± 87.0) and (641.4 ± 60.3), respectively, were higher in the SIMV group than in the control group [(401.1 ± 74.5) and (381.3 ± 63.3) , PAV group was higher than MAS group, the difference was statistically significant (P all <0.05). (3) Compared with control group (301.8 ± 75.9), SIMV (P <0.05). The levels of IL-8 in PAV, SIMV and MAS groups were significantly higher than those in PAV group [(653.0 ± 93.3), (744.7 ± 81.8) and (532.4 ± 60.1) Higher than the control group (280.9 ± 70.8), SIMV group was higher than the PAV group and MAS group, PAV group was higher than the MAS group, the difference was statistically significant (P all <0.05). Conclusion Meconium can promote the release of TNF-α and IL-8 in the inflammatory reaction. The degree of lung injury induced by PAV in MAS is less than SIMV.