论文部分内容阅读
为探讨海水淹溺肺水肿（PE－SWD）的发生机理，应用丹麦产ABL-Ⅲ型血气-酸碱分析仪，对兔动脉血气和酸碱指标进行自动检测；采用计算机图像分析系统，对肺Na+－K+－ATPase、细胞色素氧化酶（CYTO）和碱性磷酸酶（ALP）进行自动检测和定量分析；采用原位杂交和免疫组化技术，对肺组织C－fosmRNA和Fos蛋白进行定量检测；采用磷脂和Ca2+超微结构定位方法，对肺磷脂和Ca2+的分布进行定位定量观察。结果表明：PE-SWD组动脉氧分压（PaO2）、血氧饱和度（SaO2）、pH值、实际碳酸氢盐（AB）、剩余减（BE）、肺Na+－K+－ATPase和CYTO显著降低。PE－SWD组兔肺上皮组织中ALP、c－fosmRNA和Fos蛋白的表达水平比正常对照组（NC）明显升高（P＜0.01）。PE－SWD组肺泡Ⅱ型上皮细胞磷脂反应产物明显减少，肺毛细血管内皮细胞和肺泡Ⅰ、Ⅱ型上皮细胞Ca2+沉淀颗粒明显增多。作者认为，海水损伤性作用、低氧血症和代谢世酸中毒是PE－SWD发生机制中三种重要因素。肺Na+－K+－ATPase、CYTO活力降低和细胞内钙超载既是上述三大因素造成的直接恶果，又是促进PE－SED不断发生发展的继发性原因。Ca2+－fos传导途径可能也是导致PE－SWD不断恶化的重要环节。
In order to explore the mechanism of PE-SWD, arterial blood gas and acid-base indexes of rabbit were detected automatically by ABL-Ⅲ blood gas-acid-base analyzer in Denmark. Using computer image analysis system, Na + -K + -ATPase, Cytochrome oxidase (CYTO) and Alkaline phosphatase (ALP) were detected and quantitated automatically. C-fos mRNA and Fos protein were detected by in situ hybridization and immunohistochemistry Phospholipid and Ca2 + ultrastructure were used to locate the distribution of pulmonary phospholipid and Ca2 +. The results showed that PaO2, SaO2, pH, AB, BE, Na + -K + -ATPase and CYTO were significantly decreased in PE-SWD group . The levels of ALP, c-fos mRNA and Fos protein in PE-SWD group were significantly higher than those in normal control group (P <0.01). The products of phospholipid reaction of alveolar type Ⅱ epithelial cells in PE-SWD group were significantly decreased, the number of Ca2 + precipitates in pulmonary capillary endothelial cells and alveolar type Ⅰ and type Ⅱ epithelial cells was significantly increased. The author believes that seawater damage, hypoxemia and metabolic acidosis are three important factors in the mechanism of PE-SWD. Pulmonary Na + -K + -ATPase, CYTO activity decreased and intracellular calcium overload is not only the direct result of the above three factors, but also to promote PE-SED continuous development of secondary causes. Ca2 + -fos pathway may also lead to PE-SWD deteriorating an important part.