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目的探讨肺复张方法和潮气量对急性呼吸窘迫综合征(ARDS)家兔肺泡灌洗液(BALF)中TNF-α、IL-8及IL-10的影响。方法建立ARDS家兔模型,用ELISA法检测不同组别家兔BALF中的TNF-α、IL-8及IL-10,并比较检测结果。结果呼气末正压(PEEP)递增法组BALF中的TNF-α、IL-8显著低于控制性肺膨胀(SI)组及ARDS组,而IL-10显著高于SI组及ARDS组(均P<0.01)。不同潮气量中,小潮气量组BALF中的TNF-α、IL-8显著低于其他潮气量组,而IL-10显著高于其他潮气量组(均P<0.01)。PEEP递增法组中,小潮气量组BALF中的TNF-α、IL-8显著低于其他潮气量组,而IL-10显著高于其他潮气量组(均P<0.01)。结论 PEEP递增法+小潮气量可抑制ARDS家兔BALF中的TNF-α、IL-8的释放,增加IL-10的释放,减轻肺内炎症反应。
Objective To investigate the effects of pulmonary regurgitation and tidal volume on the levels of TNF-α, IL-8 and IL-10 in BALF of acute respiratory distress syndrome (ARDS) rabbits. Methods ARDS rabbit model was established. The levels of TNF-α, IL-8 and IL-10 in BALF of different groups of rabbits were detected by ELISA. The results were compared with each other. Results The levels of TNF-α and IL-8 in BALF of PEEP group were significantly lower than those of SI group and ARDS group, but IL-10 was significantly higher than that of SI group and ARDS group All P <0.01). In different tidal volumes, the levels of TNF-α and IL-8 in BALF in the low tidal volume group were significantly lower than those in other tidal volume groups, while IL-10 was significantly higher than those in other tidal volume groups (all P <0.01). In the PEEP incremental group, the levels of TNF-α and IL-8 in BALF in the low tidal volume group were significantly lower than those in other tidal volume groups, while IL-10 was significantly higher than those in other tidal volume groups (all P <0.01). Conclusions PEEP + small tidal volume can inhibit the release of TNF-α and IL-8 from BALF of ARDS rabbits, increase the release of IL-10 and reduce the inflammatory reaction in the lung.