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目的 探讨冲击波复合四氧化二氮 (N2 O4)染毒致大鼠冲毒复合伤肺组织损伤特点及其分子机制。方法 采用Wistar雄性大鼠复制冲击伤、N2 O4染毒及复合效应动物模型 ,于伤后 3,6 ,12 ,2 4 ,4 8及 72小时活杀动物 ,进行主要器官病理形态学检查 ,血气分析并采用H&E及SP免疫组化技术观察大鼠肺组织损伤病变特点及c fos蛋白表达的变化和肥大细胞的数量。结果 三组动物动脉血氧分压 (PaO2 )均在伤后 2～ 6小时内显著下降 ,以冲击伤 +N2 O4组动物下降最为显著 ,重者死于呼衰。三组动物的主要病理形态学均有改变 ,以冲击伤 +N2 O4组动物最甚 ;免疫组化显示 ,冲击伤组和N2 O4组动物c fos蛋白表达均明显增加 ,而冲击伤 +N2 O4组动物c fos表达持续呈强阳性 ,其阳性部位以支气管上皮、血管内皮和单核细胞为主。另外 ,大鼠肺组织出现大量的肥大细胞。结论 单纯冲击伤和单纯N2 O4中毒组动物早期血气均有显著变化 ;N2 O4冲毒复合伤对大鼠血气的影响最为显著。另外 ,三组动物的主要病理形态学均有改变 ,以冲击伤 +N2 O4组动物最甚 ;实验结果表明 ,c fos蛋白表达及出现大量的肥大细胞参与了冲毒复合伤对大鼠肺损伤的加重过程。提示对冲毒复合伤进行早期救治 (在染毒致伤后 2～ 6小时内 )的重要性。
Objective To investigate the characteristics and molecular mechanisms of lung injury induced by shock wave combined with nitrous oxide (N2 O4) in rats. Methods Wistar male rats were used to replicate the animal models of impact injury, N2 O4 and compound effects. The animals were sacrificed at 3, 6, 12, 24, 48 and 72 hours after injury. The main organs were pathologically examined. Blood gas Analysis and use of H & E and SP immunohistochemistry to observe the pathological changes of lung tissue injury and c fos protein expression and the number of mast cells. Results The arterial partial pressure of oxygen (PaO2) decreased significantly within 2 to 6 hours after injury in the three groups, and the most significant decrease was in the group of impact injury + N2 O4. The severe cases died of respiratory failure. The main pathomorphology of the three groups of animals were changed to impact injury + N2 O4 group of animals the most; immunohistochemistry showed that the impact injury group and N2 O4 group of animals c fos protein expression were significantly increased, while the impact injury + N2 O4 Group c fos expression continued strong positive, the positive part of bronchial epithelium, vascular endothelial cells and monocytes. In addition, a large number of mast cells appeared in rat lung tissue. Conclusions The blood gas of rats in the group of simple injury of shock and simple N2 O4 poisoning both had significant changes in the early stage. The effect of N2 O4 combined with compound poisoning on blood gas was the most significant. In addition, the main pathological morphology of the three groups of animals have changed to impact injury + N2 O4 group of animals the most; experimental results show that c fos protein expression and the emergence of a large number of mast cells involved in the red combined injury of rat lung injury The aggravating process. Prompt hemorrhagic compound injury early treatment (2 to 6 hours after exposure to poisoning) the importance.