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目的:探讨冲击波复合四氧化二氮(N_2O_4)染毒致冲毒复合伤对大鼠血气及病理形态学的影响,以及该条件下 c-fos 基因的表达及其意义。方法:采用 Wistar 雄性大鼠复制冲击伤、N_2O_4中毒及复合效应的3组动物模型,均于伤后3、6、12、24、48、72h 活杀,进行主要器官病理形态学检查及血气分析,并采用 SP 免疫组化技术观察肺组织 c-fos 基因表达的变化。结果:三组动物 PaO_2均在伤后3～6 h 内显著下降,冲毒复合伤组动物伤后 PaO_2下降最为显著,重者死于呼衰。三组动物的主要病理形态学均有改变,以冲毒复合伤组的损伤最重;冲击伤和 N_2O_4组 c-fos 基因表达均明显增加,而于复合伤组表达持续呈强阳性,其阳性部位以支气管上皮、血管内皮和单核细胞为主。结论:单纯中度冲击伤组和单纯中度 N_2O_4组中毒早期血气均有显著变化;复合伤对血气的影响更为显著。另外,三组动物的主要病理形态学均有改变,以复合伤组的损伤最重;结果表明 c-fos 基因表达可能参与复合伤对肺损伤的加重过程,提示对冲毒复合伤进行早期救治(在3～6h 内)的重要性。
Objective: To investigate the effects of shock-wave combined with nitrous oxide (N_2O_4) on the blood gas and histopathology of rats induced by reddox and the expression of c-fos gene and its significance. METHODS: Three animal models of Wistar rats were used to replicate the impact injury, N 2 O 4 poisoning and compound effects. All the animals were sacrificed at 3, 6, 12, 24, 48 and 72 hours after injury. Pathological examination and blood gas analysis were performed , And the expression of c-fos gene in lung tissue was observed by SP immunohistochemistry. Results: The PaO_2 of three groups of animals decreased significantly within 3 to 6 hours after injury, and the PaO 2 decreased most significantly after the animals were injured in the combination of redness and poisoning. The most cases died of respiratory failure. The main pathomorphology of the three groups of animals changed, and the injury was the heaviest in the combined injury group. The expressions of c-fos gene in the injured group and the N 2 O 4 group were significantly increased, while the positive expression in the combined injury group was still strong The site of bronchial epithelium, vascular endothelial cells and monocytes. CONCLUSION: The blood gas changes significantly in early stage of simple moderate impact injury group and simple moderate N_2O_4 group poisoning, and the effect of combined injury on blood gas is more significant. In addition, the main pathomorphology of the three groups of animals were changed to the most severe damage in the composite injury group; the results showed that c-fos gene expression may be involved in the process of aggravating the injury of lung injury, suggesting that early treatment In 3 ~ 6h) the importance of.