声门紧闭状态下肺撞击伤后肺微血管通透性的变化-第三军医大学学报.DOC

声门紧闭状态下肺撞击伤TNF-α表达的实验研究 吴秋平1 蒋耀光2 闵家新1 （1.第三军医大学新桥医院胸外科，重庆 400037；2.第三军医大学大坪医院野战外科研究所全军战创伤中心，重庆 400042） 摘要：目的 研究TNF-α与声门紧闭状态下闭合性胸部撞击所致肺损伤的关系。方法 采用RT-PCR法检测声门紧闭与开放状态下，不同时相点伤侧肺组织TNF-αmRNA的表达。结果 在伤后2h时，声门紧闭与开放两组TNF-αmRNA的表达无显著差别（P0.05），伤后4h、8h、12h声门紧闭组TNF-αmRNA的表达显著高于声门开放组（P0.05）αmRNA表达各时相点显著高于与对照组（P0.05）。结论 TNF-α参与创伤性肺损伤的发生发展并起重要作用，声门紧闭状态下肺撞击伤的损伤程度重于声门开放状态。 关键词：胸部创伤；撞击伤；肿瘤坏死因子-α TNF-αexpressions in lung impact injuries under the closure state of glottis WU Qiu-ping1, JIANG Yao-guang2，MIN Jia-xin1 (Department of Thoracic Surgury, Xinqiao Hospital of the Third Military University, Chongqing 400037,China) Abstract: Objective To study the TNF-αexpressions in lung injury induced by blunt chest trauma under the closure state of glottis. Methods: TNF-αmRNA expressions were detected by reverse transcription polymerase chain reaction (RT-PCR) in injuried lung tissue under the closed and open glottis states at designed time. Results: No markedly correlation was found between the expressions of TNF-αin lung tissue of closed glottis group and of the open group after 2 hours injured (P0.05). But TNF-α mRNA expressions were obviosly higher in lung tissue of closed glottis group than that in open glttis at 4h, 8h, 12h injured (P0.05). TNF-α mRNA expressions were much higher in injured lung tissue than that in control group at designed time (P0.05). Conclusions:. TNF-αwas involved in the occurrence and development of traumatic lung injuries and played a critical role in this process. The severity of lung injuries in the glottis closure group was significantly higher than that in glottis open. Keywords:　Thoracic trauma; Impact injury; TNF-α 肺是胸部撞击伤最常累及的人体重要器官，胸部撞击伤后的肺挫伤、急性肺损伤(acute lung injury，ALI)、急性呼吸窘迫综合症（acute respiratory distress syndrome，ARDS[1]。ALI的实质是各种原因引起的全身炎症反应综合征在肺部的表现，ARDS只是ALI严重阶段。目前认为创伤导致全身性炎症反应和器官功能损害时，肿瘤坏死因子(TNF-α)在机体炎症反应与抗炎反应中起关键作用[2]。在由胸部撞击致肺损伤的过程中,炎症细胞产生TNF-α的作用尚鲜见报道。已知TNF-α具有广泛的生物活性，是引起组织细胞损伤的重要介质。为此，本研究采用RT-PCR法检测伤侧肺组织TNF-αmRNA的表达 材料与方法 1 实验动物及分组 选取新西兰实验兔54