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目的探讨β-肾上腺素能激动剂(多巴酚丁胺)对内毒素诱导急性肺损伤肺泡液体清除的效应。方法内毒素静脉注射复制大鼠急性肺损伤模型。清洁级雄性SD大鼠32只随机分为正常对照组、急性肺损伤组、多巴酚丁胺对照组和多巴酚丁胺治疗组。单核素示踪技术测定1h肺泡液体清除率(AFC)。逆转录聚合酶链反应(RT-PCR)检测肺组织α、β、γ钠通道(rENaC)mRNA表达。结果急性肺损伤组AFC显著低于正常对照组(14·0%±1·2%vs21·0%±3·9%,P<0·05)。多巴酚丁胺对照组AFC显著高于正常对照组,多巴酚丁胺治疗组AFC(20·0%±3·9%)显著高于急性肺损伤组(均P<0·05)。急性肺损伤组和多巴酚丁胺治疗组肺组织α、β-rENaC mRNA表达显著高于正常对照组和多巴酚丁胺对照组(1·40±0·40、0·70±0·8、1·38±0·13、0·71±0·17vs1·01±0·14、0·58±0·12,均P<0·05)。多巴酚丁胺治疗组和多巴酚丁胺对照组γ-rENaC mRNA表达显著高于急性肺损伤组和正常对照组(0·90±0·19、0·97±0·15vs0·69±0·10、0·70±0·32,均P<0·05)。结论β-肾上腺素能激动剂通过上调γ-rENaC的表达,增加急性肺损伤肺泡液体清除。
Objective To investigate the effect of β-adrenergic agonist (dobutamine) on alveolar fluid clearance induced by endotoxin in acute lung injury. Methods Endotoxin was injected intravenously into a rat model of acute lung injury. Thirty-two male SD rats were randomly divided into normal control group, acute lung injury group, dobutamine control group and dobutamine treatment group. Mononuclear tracer technique was used to determine alveolar fluid clearance (AFC) at 1 h. Reverse transcription polymerase chain reaction (RT-PCR) was used to detect the expression of α, β, γ sodium channel (rENaC) mRNA in lung tissue. Results AFC in acute lung injury group was significantly lower than that in control group (14.0% ± 1.2% vs 21.0% ± 3.99%, P <0.05). The AFC in the dobutamine control group was significantly higher than that in the normal control group. The AFC in the dobutamine group was significantly higher than that in the acute lung injury group (20.0% ± 3.99%, P <0.05). The expression of α, β-rENaC mRNA in lung tissue of acute lung injury group and dobutamine treatment group was significantly higher than that of normal control group and dobutamine control group (1.40 ± 0.40, 0.70 ± 0. 8,1 · 38 ± 0 · 13,0 · 71 ± 0 · 17vs1 · 01 ± 0 · 14,0 · 58 ± 0 · 12, all P <0 · 05). The expression of γ-rENaC mRNA in dobutamine group and dobutamine control group was significantly higher than that in acute lung injury group and normal control group (0.90 ± 0.19,0.997 ± 0.15vs0.69 ± 0 · 10,0 · 70 ± 0 · 32, all P <0 · 05). Conclusion β-adrenergic agonists increase alveolar fluid clearance in acute lung injury by up-regulating the expression of γ-rENaC.