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目的 观察博莱霉素 (BLM)肺损伤早期肺泡Ⅱ型上皮细胞 (ATⅡ )的超微结构和肺表面活性物质 (PS)中磷脂 (PL)的组分和蛋白质含量的变化 ,探讨这一变化与ATⅡ活性的关系。方法 2 8只大鼠气管内滴注BLM (4mg/ml,5mg/kg)建立肺损伤模型 ,按染BLM后处死的时间顺序分为 3、7、14、2 8d组 ,大鼠的肺组织块分别行组织化学染色电镜观察 ,测定支气管灌洗液 (BALF)中PL及其组分和蛋白质含量。结果 (1)染BLM实验组大鼠肺均可见PS层丧失连续、均匀的绒状结构 ,脱落入肺泡腔 ,以 3d组较为明显。钌红阳性表面层的厚度与对照组比较 ,3d组大鼠肺较厚且染色深 ,7、14d组无明显差别 ,2 8d组较淡薄 ;BALF的PS中PL含量趋于增加 ,其中 3d组大鼠的磷脂酰甘油 (PG)含量升高 ,7、14、2 8d组降低 ;磷脂酰肌醇 (PI)含量变化则与此相反。 (2 )染BLM 3、7d组大鼠ATⅡ可见变性坏死 ,甚至崩解 ,以 3d组较明显 ;ATⅡ增生各组均可见 ,以 7d组较明显 ;14d组可见有ATⅡ转化为ATⅠ ,并伸展、粘附于裸露基底膜 ;3d组大鼠肺PS中蛋白质的含量最高 ,2 8d组含量接近对照组。结论 BLM肺损伤后PS的形态以及质与量的变化能较特异的反映ATⅡ活性。测定BALF中PL含量是判断肺损伤早期ATⅡ活性变化的简便易行的方法之一。
Objective To observe the ultrastructure of alveolar type Ⅱ epithelial cells (AT Ⅱ) and the content of phospholipids (PL) in pulmonary surfactant (PS) in bleomycin (BLM) And AT Ⅱ activity relationship. Methods Twenty-four rats were intratracheally instilled with BLM (4mg / ml, 5mg / kg) to establish a model of lung injury. The rats were divided into 3, 7, 14, The blocks were examined by histochemical staining, and the content of PL and its components and protein in bronchoalveolar lavage fluid (BALF) were determined. Results (1) In the lungs of BLM experimental group, the continuous and uniform vellus structure was lost in the PS layer, which was shed into the alveolar space, especially in the 3d group. The thickness of ruthenium-red positive surface layer in rats of 3d group was thicker and stained darker than that in control group, there was no significant difference in 7,14d group and lighter in 28d group, while the content of PL in BALF tended to increase In rats, the content of phosphatidylglycerol (PG) increased, and the level of phosphatidylinositol (PI) decreased on the 7th, 14th and 28th days. (2) The ATⅡ of BLM 3,7d group showed degeneration, necrosis and even disintegration, which was more obvious in 3d group; ATⅡ hyperplasia was seen in all groups, obvious in 7d group; ATⅡ was transformed into ATⅠ in 14d group, , Adhered to the bare basement membrane. The content of protein in lungs of rats in 3d group was the highest, and that in 28d group was close to control group. Conclusion The changes of PS morphology and the quantity and quality of BL after BLM lung injury can reflect ATⅡ activity more specifically. Determination of PL content in BALF is one of the simple and easy ways to determine the change of ATⅡ activity in the early stage of lung injury.