目的:观察环孢素A(CsA)对博来霉素(BLM)所致肺间质病变的治疗作用,并探讨其作用机制。方法:将120只C57BL/6小鼠随机分为5组,模型组、模型对照组、CsA30mg治疗组、CsA50 mg治疗组和治疗对照组,每组24只;模型组及治疗组小鼠均经气管滴入BLM建立肺间质病变模型,模型对照组小鼠则经气管滴入同体积生理盐水。于造模当日起,治疗组经腹腔注射CsA,治疗对照组经腹腔注射等体积生理盐水,模型组及模型对照组不予治疗。在实验第4、7和14天分别抽取小鼠外周血,用细胞计数板计数白细胞总数,以流式细胞术检测CD4+T细胞、CD14+单核细胞和CD19+B细胞的数量比例;同步取支气管肺泡灌洗液(BLAF)细胞计数及细胞涂片Giemsa染色分析;并进行肺组织病理学研究。结果:模型组外周血白细胞总数明显升高,细胞分类显示CD14+单核细胞和CD19+B细胞在造模4 d、7 d、14 d均较模型对照组显著增高。CsA治疗后,CD14+细胞比例在4 d时下降最为明显,显著低于同一时间点模型组;7 d、14 d亦低于同一时间点模型组;治疗组CD19+B细胞比例在7 d、14 d时均显著低于同一时间点模型组,各组间CD4+T细胞比较均未见明显统计学差异;BALF细胞分析显示,模型组4 d、7 d、14 d时细胞总数及分类计数均明显高于同一时间点模型对照组,CsA治疗后均显著减少;肺组织病理学观察可见,在第4～14天,模型组及治疗对照组小鼠肺间质内浸润细胞逐渐增多,其中以淋巴细胞浸润为主,可见少量单核-巨噬细胞浸润,同时见间质内胶原纤维沉积逐渐增多。CsA治疗组小鼠肺间质炎症明显减轻,间质内及小支气管周围胶原纤维沉积减少;免疫组化研究显示,模型组小鼠和治疗对照组肺内组织内浸润的单核-巨噬细胞、中性粒细胞和淋巴细胞均高表达CD147分子,治疗组肺内表达CD147的细胞减少。结论:环孢素A可能通过抑制CD147-CypA的相互作用,抑制炎性细胞向肺内的趋化聚集,减轻肺部炎症、减少胶原沉积。 Objective: To observe the therapeutic effect of cyclosporin A (CsA) on bleomycin (BLM) -induced interstitial lung disease and to explore its mechanism. Methods: 120 C57BL / 6 mice were randomly divided into five groups: model group, model control group, CsA30mg treatment group, CsA50mg treatment group and treatment control group, with 24 rats in each group.Model group and treatment group Intratracheal intratracheal instillation of BLM was used to establish the model of interstitial lung disease. The mice in the model control group were injected with the same volume of normal saline through the trachea. From the day of model making, the treatment group was injected intraperitoneally with CsA. The control group was injected with equal volume of normal saline by intraperitoneal injection. The model group and the model control group were not treated. On the 4th, 7th and 14th days of the experiment, the peripheral blood of mice was drawn, the total number of white blood cells was counted by the cell counting plate, and the number proportion of CD4 + T cells, CD14 + monocytes and CD19 + B cells was detected by flow cytometry; Bronchoalveolar lavage fluid (BLAF) cell count and cell smear Giemsa staining; and lung histopathology. Results: The total number of peripheral leukocytes in the model group was significantly higher than that in the model control group. The cell classification showed that CD14 + monocytes and CD19 + B cells were significantly increased at 4 d, 7 d and 14 d after model establishment. After CsA treatment, the proportion of CD14 + cells decreased most significantly at 4 days, significantly lower than that of the model group at the same time point, and also lower than the model group at 7 and 14 days after treatment with CsA. The proportion of CD19 + B cells in the treatment group was 7 days and 14 days d were significantly lower than the model group at the same time point, there was no significant difference in the CD4 + T cells between the groups; BALF cell analysis showed that the total number of cells and the classification of the model group at 4 d, 7 d, 14 d Significantly higher than the model control group at the same time point, CsA treatment were significantly reduced; lung histopathological observation shows that in the first 4 to 14 days, the model group and the control group mice interstitial infiltrating cells gradually increased, of which Lymphocyte infiltration, showing a small amount of monocyte - macrophage infiltration, while see the interstitial collagen deposition gradually increased. In mice treated with CsA, interstitial inflammation was significantly reduced and interstitial and peribronchial collagen deposition was decreased. Immunohistochemistry showed that the number of infiltrating mononuclear macrophages , Neutrophils and lymphocytes were high expression of CD147 molecules, the treatment group lung CD147 expression of cells decreased. Conclusion: Cyclosporine A can inhibit the adhesion of CD147-CypA, inhibit the chemotaxis of inflammatory cells to lung, reduce the inflammation of lung and reduce the deposition of collagen.