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目的探讨严重肺挫伤及缺血再灌注后早期肺泡灌洗液中(BALF)及血清中TNF-α动态与肺形态学的关系。方法75只实验兔随机分为对照组A(n=25)、实验组B(LC,n=25)及C(LIRI,n=25);检测各组0,1,2,3,4h肺功能变化及BAlF中SP-A、B、C、D含量百分比,组织病理及电镜检查。结果B、C组1h血清及BALF中TNF-α浓度开始上升,2～3h间达到顶峰,3～4h间又急剧下降;而对照组血清及BALF中TNF-α浓度无明显变化。B、C组1～4h肺泡II型细胞电镜及病理检查呈不同程度的炎症及变性改变且持续加重。结论严重肺挫伤及缺血再灌注后1～3hBALF及血清中TNF-α持续升高,与肺泡II型细胞病理改变相一致。
Objective To investigate the relationship between TNF-α and lung morphology in patients with severe pulmonary contusion, early bronchoalveolar lavage fluid (BALF), and serum after I / R. Methods 75 experimental rabbits were randomly divided into control group A (n = 25), experimental group B (LC, n = 25) and C (LIRI, n = 25) Function changes and percentage of SP-A, B, C and D in BAlF, histopathology and electron microscopy. Results The concentration of TNF-αin serum and BALF of group B and group C began to rise at 2h and peaked at 2 ~ 3h, and dropped sharply at 3 ~ 4h. The concentration of TNF-α in serum and BALF of control group did not change significantly. B, C group 1 ~ 4h alveolar type II cells by electron microscopy and pathological examination showed varying degrees of inflammation and degeneration changes and continued to increase. Conclusions Serum levels of TNF-α in severe pulmonary contusion, ischemia and reperfusion 1 ~ 3h after pneumothorax are continuously increased, which are consistent with the pathological changes of type II alveolar cells.