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目的研究抗氧化剂N-乙酰半胱氨酸(NAC)对大鼠慢性支气管炎(CB,chronic bronohi-tis)与肺气肿形成的影响。方法24只健康雄性Wistar大鼠用完全随机设计随机分为4组,A组(假吸烟组)(n=6)、B组(慢性支气管炎并肺气肿组)(n=6)、C组(NAC预防组)(n=6)、D组(NAC治疗组)(n=6),B、C及D组采用两次气管内注入脂多糖(LPS)及烟熏4周法制备慢性支气管炎并肺气肿大鼠模型,C组均在烟熏及气管内注入脂多糖前每天给予NAC(50mg/只)灌胃,D组在第15~28天烟熏前每天给予NAC(50mg/只)灌胃。各组对肺组织行HE染色观察肺泡面积改变。结果B组小气道均存在纤毛损伤、上皮细胞变性坏死糜烂脱落、黏液杯状细胞增生、气道管壁黏膜充血水肿、管壁炎性细胞浸润(淋巴细胞、中性粒细胞、单核细胞)(P<0·05),B组每只大鼠平均肺泡面积比A组增大(P<0·05),均符合慢性支气管炎并肺气肿的病理改变。C组及D组与B组比较:给予NAC防治的C组及D组小气道炎症减轻(P<0·05),则其肺泡面积减小(P<0·05),C组与A组比较肺泡面积差异无统计学意义(P>0·05),说明C组肺气肿不明显,与A组比较D组大鼠仍有一定程度的肺气肿(P<0·05)。结论NAC抗氧化可抑制由吸烟及脂多糖诱导的大鼠慢性支气管炎并肺气肿的小气道炎症、拮抗小气道损伤及防治肺气肿形成。
Objective To investigate the effect of antioxidant N-acetyl cysteine (NAC) on the formation of chronic bronchitis and emphysema in rats. Methods Twenty-four healthy male Wistar rats were randomly divided into 4 groups: group A (fake smoking group) (n = 6), group B (chronic bronchitis and emphysema group) (n = 6) (NAC group) (n = 6), group D (nAC group) (n = 6), groups B, C and D were treated with intratracheal instillation of lipopolysaccharide (LPS) Bronchitis and emphysema rats model, C group were given NAC (50mg / only) intragastrically before intubation and intratracheal instillation of lipopolysaccharide, group D was given daily NAC (50mg / Only) gavage. The lung tissue of each group was subjected to HE staining to observe the alveolar area changes. Results Small airway in group B had ciliated injury, degeneration and necrosis of epithelial cells, goblet cell proliferation, airway wall mucosal congestion and edema, inflammatory cell infiltration in the wall (lymphocytes, neutrophils, monocytes) (P <0.05). The mean alveolar area of each rat in group B was higher than that in group A (P <0.05), which accorded with the pathological changes of chronic bronchitis and emphysema. Group C and group D were compared with group B: Alveolar area was decreased (P <0.05) in group C and group D when NAC was given (P <0.05), group C and group A There was no significant difference in the area of alveoli between the two groups (P> 0.05), indicating that the emphysema in group C was not obvious. Compared with group A, there was still a certain degree of emphysema in group D (P <0.05). Conclusion Antioxidant NAC can inhibit small airway inflammation in rats with chronic bronchitis and emphysema induced by smoking and lipopolysaccharide, antagonize the injury of small airways and prevent the formation of emphysema.