医用几丁糖对兔脓胸胸膜粘连及纤维化的影响研究
|
摘要
目的探讨医用几丁糖对兔脓胸胸膜粘连及纤维化的影响。方法选取20只新西兰大耳白兔,随机分为实验组及对照组,予肺炎链球菌建立脓胸模型,实验组予胸腔内注射几丁糖2ml,对照组注射生理盐水2ml,通过检测胸水常规及生化指标及胸腔粘连情况及组织化学检测,判断胸膜粘连及纤维化情况。结果 20只兔17只完成实验,3只中途死亡,所有模型均符合脓胸标准。实验组48h及96h胸水中白细胞、中性粒细胞比值均较对照组降低,实验组96h胸水葡萄糖含量增高,实验组96h胸水量及蛋白含量降低(P<0.05)。实验组胸膜粘连评分及胸膜厚度均明显低于对照组(P<0.001)。免疫组化结果显示:实验组与对照组相比转化生长因子-β1(TGF-β1)表达下降,核心蛋白聚糖(DNC)表达上调,差异有统计学意义(P<0.001)。结论几丁糖早期干预脓胸,可通过抑制促纤维化因子TGF-β1,促进抗纤维化因子DNC的表达,以达到改善胸膜粘连,抑制胸膜纤维化的目的,为临床降低胸膜粘连及纤维化提供临床资料。
Objective To investigate the clinical of chitosan on the pleural adhesions and fibrosis in rabbits. Methods Total of 20 male New Zealand white rabbits were randomly divided into experimental group and control group. The rabbit empyema model was established by pneumococcal infection. The treatment group was treated with an intrapleural injection of chitosan 2 ml,and the control group was injected with saline 2 ml. The routine and biochemical indexes of pleural effusion,pleural adhesion and histochemical examination were used to determine pleural adhesions and fibrosis. Results Total of 20 male New Zealand white rabbits,17 experiments were completed and all models met the standard of empyema. The WBC number,the neutrophil ratio in the experimental group were significantly lower than the control group after the operation at 48,96 hours( P< 0. 05). The chest water and protein content in the experimental group were significantly lower than the control group after the operation at 96 hours( P < 0. 05). The glucose content in the experimental group was significantly higher than the control group after the operation at 96 hours( P < 0. 05). The pleural adhesion score,the pleural thickness in the experimental group were significantly lower than the control group( P < 0. 001). Immunohistochemistry showed that the transforming growth factor beta 1 in the experimental group was significantly lower than the control group,and the decorin was significantly higher than the control group( P < 0. 001). Conclusion Chitosan early intervention of empyema,which can inhibit fibrosis factor TGF-beta 1 promotes and promotes the expression of antifibrosis factor DNC,in order to improve the inhibition of pleural adhesions,pleural fibrosis,and provide clinical data for the clinical to reduce pleural adhesions and fibrosis.
Objective To investigate the clinical of chitosan on the pleural adhesions and fibrosis in rabbits. Methods Total of 20 male New Zealand white rabbits were randomly divided into experimental group and control group. The rabbit empyema model was established by pneumococcal infection. The treatment group was treated with an intrapleural injection of chitosan 2 ml,and the control group was injected with saline 2 ml. The routine and biochemical indexes of pleural effusion,pleural adhesion and histochemical examination were used to determine pleural adhesions and fibrosis. Results Total of 20 male New Zealand white rabbits,17 experiments were completed and all models met the standard of empyema. The WBC number,the neutrophil ratio in the experimental group were significantly lower than the control group after the operation at 48,96 hours( P< 0. 05). The chest water and protein content in the experimental group were significantly lower than the control group after the operation at 96 hours( P < 0. 05). The glucose content in the experimental group was significantly higher than the control group after the operation at 96 hours( P < 0. 05). The pleural adhesion score,the pleural thickness in the experimental group were significantly lower than the control group( P < 0. 001). Immunohistochemistry showed that the transforming growth factor beta 1 in the experimental group was significantly lower than the control group,and the decorin was significantly higher than the control group( P < 0. 001). Conclusion Chitosan early intervention of empyema,which can inhibit fibrosis factor TGF-beta 1 promotes and promotes the expression of antifibrosis factor DNC,in order to improve the inhibition of pleural adhesions,pleural fibrosis,and provide clinical data for the clinical to reduce pleural adhesions and fibrosis.
引文
[1]黄永旺,范学政.几丁糖与聚乳酸合成生物材料修复周围神经缺损[J].中国组织工程研究,2015,19(25):4059-4063.
[2]Liu X,Duan H,Wang YJ.Clinical characteristics and reproductive outcome following hysteroscopic adhesiolysis of patients with intrauterine adhesion-a retrospective study[J].Clinical and Experimental Obstetrics&Gynecology,2014,41(2):144-148.
[3]王丹,潘长清,邓艳梅,等.重度宫腔粘连分离术后不同方法预防再粘连的比较研究[J].实用妇产科杂志,2016,32(8):629-631.
[4]邓波,胡元斌,王静成,等.几丁糖联合带线锚钉Kessler缝合法治疗急性跟腱断裂[J].临床骨科杂志,2016,19(6):740-742.
[5]Peterson GE,Silva SS,Amantea SL,et al.Accuracy of complement activation product levels to detect infected pleural effusion in rats[J].Pediatric Pulmonology,2017,52(6):757-762.
[6]Cvijanovic V,Vojvodic D,Djurdjevic D,et al.Experimental pleural empyema model in rabbits:Why,how and what are the next steps[J].Vojnosanitetski Pregled,2014,71(5):491-498.
[7]Komissarov AA,Florova G,Azghani AO,et al.Dose dependency of outcomes of intrapleural fibrinolytic therapy in new rabbit empyema models[J].American Journal of Physiology-Lung Cellular and Molecular Physiology,2016,311(2):L389-L399.
[8]Sasse S,Jadus MG.Pleural fluid transforming growth factor-β1correlates with pleural fibrosis in experimental empyema[J].American Journal of Respiratory&Critical Care Medicine,2003,168(6):700-705.
[9]Grande JP.Role of transforming growth factor-beta in tissue injury and repair[J].Experimental Biology and Medicine,1997,214(1):27-40.
[10]Yamaguchi Y,Mann DM,Ruoslahti E.Negative regulation of transforming growth factor-beta by the proteoglycan decorin[J].Nature,1990,346(6281):281-284.
[11]Zhang Z,Li XJ,Liu Y,et al.Recombinant human decorin inhibits cell proliferation and downregulates TGF-beta(1)production in hypertrophic scar fibroblasts[J].Burns,2007,33(5):634-641.
[12]夏长所,洪光祥,李红,等.几丁糖对肌腱腱鞘和腱外膜以及腱内膜细胞增殖和胶原产生的影响[J].中华显微外科杂志,2005,28(2):154-156.
[13]Hu JC,Fan DJ,Lin XT,et al.Safety and efficacy of Sodium hyaluronate gel and chitosan in preventing postoperative peristomal adhesions after defunctioning enterostomy a prospective randomized controlled trials[J].Medicine,2015,94(51):e2354.
[14]肖天慧,乐爱文,卓蓉,等.联合应用几丁糖、球囊支架在预防重度宫腔粘连术后再粘连的效果分析[J].重庆医科大学学报,2017(4):433-436.
[2]Liu X,Duan H,Wang YJ.Clinical characteristics and reproductive outcome following hysteroscopic adhesiolysis of patients with intrauterine adhesion-a retrospective study[J].Clinical and Experimental Obstetrics&Gynecology,2014,41(2):144-148.
[3]王丹,潘长清,邓艳梅,等.重度宫腔粘连分离术后不同方法预防再粘连的比较研究[J].实用妇产科杂志,2016,32(8):629-631.
[4]邓波,胡元斌,王静成,等.几丁糖联合带线锚钉Kessler缝合法治疗急性跟腱断裂[J].临床骨科杂志,2016,19(6):740-742.
[5]Peterson GE,Silva SS,Amantea SL,et al.Accuracy of complement activation product levels to detect infected pleural effusion in rats[J].Pediatric Pulmonology,2017,52(6):757-762.
[6]Cvijanovic V,Vojvodic D,Djurdjevic D,et al.Experimental pleural empyema model in rabbits:Why,how and what are the next steps[J].Vojnosanitetski Pregled,2014,71(5):491-498.
[7]Komissarov AA,Florova G,Azghani AO,et al.Dose dependency of outcomes of intrapleural fibrinolytic therapy in new rabbit empyema models[J].American Journal of Physiology-Lung Cellular and Molecular Physiology,2016,311(2):L389-L399.
[8]Sasse S,Jadus MG.Pleural fluid transforming growth factor-β1correlates with pleural fibrosis in experimental empyema[J].American Journal of Respiratory&Critical Care Medicine,2003,168(6):700-705.
[9]Grande JP.Role of transforming growth factor-beta in tissue injury and repair[J].Experimental Biology and Medicine,1997,214(1):27-40.
[10]Yamaguchi Y,Mann DM,Ruoslahti E.Negative regulation of transforming growth factor-beta by the proteoglycan decorin[J].Nature,1990,346(6281):281-284.
[11]Zhang Z,Li XJ,Liu Y,et al.Recombinant human decorin inhibits cell proliferation and downregulates TGF-beta(1)production in hypertrophic scar fibroblasts[J].Burns,2007,33(5):634-641.
[12]夏长所,洪光祥,李红,等.几丁糖对肌腱腱鞘和腱外膜以及腱内膜细胞增殖和胶原产生的影响[J].中华显微外科杂志,2005,28(2):154-156.
[13]Hu JC,Fan DJ,Lin XT,et al.Safety and efficacy of Sodium hyaluronate gel and chitosan in preventing postoperative peristomal adhesions after defunctioning enterostomy a prospective randomized controlled trials[J].Medicine,2015,94(51):e2354.
[14]肖天慧,乐爱文,卓蓉,等.联合应用几丁糖、球囊支架在预防重度宫腔粘连术后再粘连的效果分析[J].重庆医科大学学报,2017(4):433-436.