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目的探讨肺灌洗治疗百草枯(paraquat,PQ)中毒的效果。方法 18只家兔随机分为3个组:PQ染毒组,生理盐水(NS)对照组及PQ+肺灌洗组,每组6只。PQ染毒组给予50 mg/kg PQ一次性灌胃;NS对照组给予等体积0.9%NS一次性灌胃,24 h后给予5 ml 0.9%NS肺灌洗;PQ+肺灌洗治疗组给予50 mg/kg PQ一次性灌胃,24 h后给予等量0.9%NS肺灌洗。分别在染毒前及染毒后第1、3和7天取各组动物血标本并在染毒后7 d处死动物,进行血清中髓过氧化物酶(MPO)、羟脯氨酸(Hyp)、白介素1(IL-1)、肿瘤坏死因子α(TNF-α)的含量检测及肺组织病理学检查。结果PQ染毒组肺组织肉眼及光学显微镜检查表现为急性肺损伤;PQ+肺灌洗组肺组织病理改变表现为部分细支气管周围炎细胞浸润,小血管扩张充血。PQ染毒组MPO、IL-1、TNF-α含量染毒后1、3和7 d高于NS对照组,Hyp浓度染毒后3和7 d高于NS对照组;PQ+肺灌洗组血清MPO、TNF-α含量染毒后1、3和7 d均高于NS对照组,IL-1、Hyp染毒后3和7 d高于NS对照组;PQ+肺灌洗组MPO、Hyp、IL-1、TNF-α分别在染毒后1~7 d、7 d、3~7 d、1~3 d低于PQ染毒组,差异有统计学意义(P<0.05,P<0.01)。结论肺灌洗疗法可降低急性肺损伤的炎症反应,有利于改善家兔PQ中毒所致的肺损伤,延缓肺纤维化。
Objective To investigate the effect of pulmonary lavage on paraquat (PQ) poisoning. Methods Eighteen rabbits were randomly divided into three groups: PQ-treated group, NS-treated group and PQ + lung-lavage group, 6 rats in each group. PQ group was given a single intragastric administration of 50 mg / kg PQ; the NS control group was given a single intragastric administration of 0.9% NS in an equal volume and 5 ml 0.9% NS lung lavage 24 hours later; and the PQ + mg / kg PQ once a gavage, given an equal amount of 0.9% NS lung lavage after 24 h. The blood samples of each group were taken before and at 1, 3 and 7 days after exposure, and the animals were sacrificed on the 7th day after exposure. The serum levels of MPO, Hyp ), Interleukin-1 (IL-1) and tumor necrosis factor-α (TNF-α) in lung tissue and lung histopathological examination. Results PQ group showed acute lung injury by macroscopic and optical microscopy. Pathological changes of lung tissue in PQ + lung lavage group showed partial bronchiole inflammatory cell infiltration and small blood vessel dilatation and congestion. The levels of MPO, IL-1 and TNF-αin PQ group were higher than those in NS control group at 1, 3 and 7 d after exposure, and were higher than those in NS control group at 3 and 7 d after Hyp exposure The concentrations of MPO and TNF-α were higher than those of the NS control group at 1, 3 and 7 d after exposure, and the levels of MPO, Hyp, IL (P <0.05, P <0.01). The difference was statistically significant (P <0.05, P <0.01). The levels of TNF-α and TNF-α were lower in PQ group than those in PQ group at 1-7 days, 7 days, 3-7 days and 1-3 days respectively. Conclusion Pulmonary lavage therapy can reduce the inflammatory reaction of acute lung injury, improve the lung injury caused by PQ poisoning in rabbits and delay the pulmonary fibrosis.