目的 探討不同時(shí)程( 1. 5 h 和3 h) 和程度( 15% 和12. 5% ) 睡眠誘導(dǎo)低氧( SIH) 對(duì)肺氣腫大鼠肺氣腫程度和凝血功能的影響。方法 30 只Wistar 大鼠隨機(jī)分為三組, 每組10 只。所有大鼠每天2 次暴露于香煙煙霧共1 h( 每次30 min) 。第29 d 起, 短時(shí)SIH 肺氣腫組( A 組) 同時(shí)在睡眠時(shí)段暴露于含12. 5% 氧氣的混合氣體中共1. 5 h( 分4 次給予, 每次22. 5 min) ; 輕度SIH 肺氣腫組( B 組) 同時(shí)在睡眠時(shí)段暴露于含15% 氧氣的混合氣體中共3 h( 分4 次給予, 每次45 min) ; 標(biāo)準(zhǔn)SIH肺氣腫組( C 組) 同時(shí)在睡眠時(shí)段暴露于含12. 5% 氧氣的混合氣體中共3 h( 分4 次給予, 每次45 min) 。各組大鼠均連續(xù)暴露56 d 后處死, 采集肺組織和全血。肺組織切片染色后經(jīng)半定量圖像分析, 計(jì)算肺病理評(píng)分、肺平均內(nèi)襯間隔( MLI) 和平均肺泡數(shù)( MAN) 評(píng)價(jià)肺組織病理學(xué)改變。而后測(cè)定全血中抗凝血酶Ⅲ( ATⅢ) 、纖維蛋白原( FIB) 、血管性血友病因子( vWF) 、凝血因子Ⅷ( FⅧ) 的活性。以SPSS 11. 5 進(jìn)行統(tǒng)計(jì)學(xué)處理, 采用單因素方差分析行組間比較, 組內(nèi)比較采用SNK-q 檢驗(yàn)。結(jié)果 三組大鼠肺組織切片均呈現(xiàn)明顯肺氣腫樣改變。各組肺病理評(píng)分和MLI 差異明顯( F =21. 907, F =18. 415, P 均 lt; 0. 05) , A 組[ ( 61.90 ±4. 25) % , ( 92. 45 ±1. 78) μm] 和B 組[ ( 64.60 ±3. 95) % , ( 92. 80 ±3. 65) μm] 均低于C 組[ ( 73. 30 ±3. 86) % , ( 99. 32 ±2. 81) μm, q =8. 96, q =6. 84,q = 12. 64, q =9. 65, P 均 lt;0. 05] 。各組全血FIB 差異明顯( F = 20. 592, P lt; 0. 05) , A 組[ ( 189. 98 ±5. 29) mg / dL] 和B 組[ ( 182. 70 ±2. 78) mg/dL] 均低于C 組[ ( 198. 40 ±7. 37) mg/ dL, q= 4. 86, q =9. 07, P 均 lt;0. 05] , 且A 組高于B 組( q =4. 20, P lt; 0. 05) 。各組全血FⅧ 的差異明顯( F = 33. 652,P lt;0. 05) , A 組[ ( 232.26 ±4. 17) % ] 和B 組[ ( 242.53 ±14. 50) % ] 均低于C 組[ ( 303.25 ±32. 93) % , q = 10. 73, q =9. 18, P 均 lt; 0. 05] 。結(jié)論 標(biāo)準(zhǔn)SIH 肺氣腫大鼠的肺氣腫程度和血液高凝狀態(tài)均較短時(shí)、輕度SIH肺氣腫大鼠加重。凝血因子的增強(qiáng)在高凝狀態(tài)的加重中占主導(dǎo)作用。
引用本文: 姚我 ,馮靖,吳琦,陳寶元,門(mén)劍龍,任靜,張澤麗. 不同時(shí)程和程度睡眠低氧對(duì)肺氣腫大鼠肺氣腫程度和凝血功能的影響. 中國(guó)呼吸與危重監(jiān)護(hù)雜志, 2009, 09(6): 524-527. doi: 復(fù)制
1. | 中華醫(yī)學(xué)會(huì)呼吸病學(xué)分會(huì)慢性阻塞性肺疾病學(xué)組. 慢性阻塞性肺疾病診治指南(2007年修訂版). 中華結(jié)核和呼吸雜志,2007,30: 8-17. |
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5. | Vernooy JH,Dentener MA,van RJ,et al. Long-term intratracheal lipopolysaccharide exposure in mice results in chronic lung inflammation and persistent pathology. Am J Respir Cell Mol Biol,2002,26: 152-159. |
6. | Liu F. Receptor-regulated Smads in TGF-beta signaling. Front Biosci,2003,8: S1280-S1303. |
7. | Nikolaou E,Trakada G,Prodromakis E,et al. Evaluation of Arterial Endothelin-1 Levels,before and during a Sleep Study,in Patients with Bronchial Asthma and Chronic Obstructive Pulmonary Disease. Respiration,2003,70: 606-610. |
8. | Orem JM,Lovering AT,Vidruk EH. Excitation of medullary respiratory neurons in REM sleep. Sleep,2005,28: 801-807. |
9. | Dahl M,Tybjaerg-Hansen A,Vestbo J,et al. Elevated plasma fibrinogen associated with reduced pulmonary function and increased risk of chronic obstructive pulmonary disease. Am J Respir Crit Care Med,2001,164: 1008-1011. |
10. | 姜正華,呂元文,朱慕云,等. 慢性阻塞性肺疾病患者血?dú)夥治雠c血漿纖維蛋白原的相關(guān)性研究. 實(shí)用診斷與治療雜志,2006,20: 13-14. |
11. | 宋麗娜,董小黎,周以健. 急性缺氧時(shí)內(nèi)皮細(xì)胞中vWF的變化. 中華血液學(xué)雜志,2000,21: 475-477. |
12. | 謝飛,王鴻利. 凝血因子Ⅷ結(jié)構(gòu)與功能關(guān)系的研究進(jìn)展. 國(guó)外醫(yī)學(xué)臨床生物化學(xué)與檢驗(yàn)學(xué)分冊(cè),2005,26: 932-939. |
- 1. 中華醫(yī)學(xué)會(huì)呼吸病學(xué)分會(huì)慢性阻塞性肺疾病學(xué)組. 慢性阻塞性肺疾病診治指南(2007年修訂版). 中華結(jié)核和呼吸雜志,2007,30: 8-17.
- 2. Casey KR,Cantillo KO,Brown LK. Sleep-Related Hypoventilation/Hypoxemic Syndromes. Chest,2007,131: 1936-1948.
- 3. 馮靖,朱寶玉. 慢性阻塞性肺疾病與夜間低氧血癥. 國(guó)外醫(yī)學(xué)呼吸系統(tǒng)分冊(cè),2003,23: 30-33.
- 4. Ashitani J,Mukae H,Arimura Y,et al. Elevated plasma procoagulant and fibrinolytic markers in patients with chronic obstructive pulmonary disease. Intern Med,2002,41: 181-185.
- 5. Vernooy JH,Dentener MA,van RJ,et al. Long-term intratracheal lipopolysaccharide exposure in mice results in chronic lung inflammation and persistent pathology. Am J Respir Cell Mol Biol,2002,26: 152-159.
- 6. Liu F. Receptor-regulated Smads in TGF-beta signaling. Front Biosci,2003,8: S1280-S1303.
- 7. Nikolaou E,Trakada G,Prodromakis E,et al. Evaluation of Arterial Endothelin-1 Levels,before and during a Sleep Study,in Patients with Bronchial Asthma and Chronic Obstructive Pulmonary Disease. Respiration,2003,70: 606-610.
- 8. Orem JM,Lovering AT,Vidruk EH. Excitation of medullary respiratory neurons in REM sleep. Sleep,2005,28: 801-807.
- 9. Dahl M,Tybjaerg-Hansen A,Vestbo J,et al. Elevated plasma fibrinogen associated with reduced pulmonary function and increased risk of chronic obstructive pulmonary disease. Am J Respir Crit Care Med,2001,164: 1008-1011.
- 10. 姜正華,呂元文,朱慕云,等. 慢性阻塞性肺疾病患者血?dú)夥治雠c血漿纖維蛋白原的相關(guān)性研究. 實(shí)用診斷與治療雜志,2006,20: 13-14.
- 11. 宋麗娜,董小黎,周以健. 急性缺氧時(shí)內(nèi)皮細(xì)胞中vWF的變化. 中華血液學(xué)雜志,2000,21: 475-477.
- 12. 謝飛,王鴻利. 凝血因子Ⅷ結(jié)構(gòu)與功能關(guān)系的研究進(jìn)展. 國(guó)外醫(yī)學(xué)臨床生物化學(xué)與檢驗(yàn)學(xué)分冊(cè),2005,26: 932-939.