小剂量红霉素对气管损伤后气管狭窄的抑制作用

发布时间：2018-10-14 10:00

【摘要】：目的探讨小剂量红霉素对气管损伤后气管狭窄的抑制作用及可能机制,探讨其用于防治气管损伤后狭窄的可能。方法42只家兔按随机数字表法分成7个组,每组家兔各6只,即:NS组为对照组,PG组为青霉素组,EM组为红霉素组,EM+PG组为红霉素+青霉素组,BS组为布地奈德组,EM+BS组为红霉素+布地奈德组,EM+PG+BS组为红霉素+青霉素+布地奈德组。各组家兔行气管切开均予以尼龙毛刷(直径约5mm)反复刷20次,建立家兔气管狭窄模型。气管切开术前1周至术后第9天,各组家兔均分别给予上述相应药物处理。术后第10天收集家兔血液标本、肺泡灌洗液(BALF)标本,酶联免疫吸附(ELISA)法检测各组家兔血清及BALF液中白细胞介素(IL)-6、IL-8、转化生长因子β1(TGF-β1)、血管内皮生长因子(VEGF)的浓度,并且取狭窄段气管测量气管狭窄度。结果给予小剂量红霉素的各实验组(EM、EM+PG、EM+BS、EM+PG+BS组)血清以及BALF中TGF-β1、VEGF、IL-6、IL-8浓度均显著低于未给予小剂量红霉素组(NS、PG、BS组)(均P0.05);EM+PG+BS组浓度均显著低于其他各组(均P0.05);NS、PG、BS组间两两比较差异均无统计学意义(均P0.05);EM、EM+PG、EM+BS组间两两比较差异均无统计学意义(均P0.05)。42只家兔气管内均有不同程度的肉芽组织增生致气管狭窄。NS、PG、EM、EM+PG、BS、EM+BS、EM+PG+BS组气管狭窄度分别为(53.3±4.4)%、(48.2±5.0)%、(24.3±4.4)%、(29.5±3.2)%、(47.8±6.5)%、(27.9±3.1)%、(15.6±2.0)%,EM、EM+PG、EM+BS、EM+PG+BS组狭窄度均显著轻于NS、PG、BS组,差异均有统计学意义,(均P0.05);EM+PG+BS组狭窄度均显著轻于其他各组,差异均有统计学意义,(均P0.05)。结论小剂量红霉素能有效抑制气管损伤后肉芽组织的过度增生,可减轻气管损伤后气管狭窄的程度以及气管狭窄治疗后的再狭窄率,与其他抗菌素及糖皮质激素联合用药时效果更佳,这可能在良性增生性气管狭窄的防治方面具有潜在的临床价值。
[Abstract]:Objective to investigate the inhibitory effect and possible mechanism of low dose erythromycin on tracheal stenosis after tracheal injury. Methods 42 rabbits were randomly divided into 7 groups with 6 rabbits in each group. That is: NS group as control group, PG group as penicillin group, EM group as erythromycin group, EM PG group as erythromycin penicillin group, BS group as budesonide group, EM BS group as erythromycin budesonide group, EM PG BS group as erythromycin penicillin budesonide group. The rabbit model of trachea stenosis was established after tracheotomy with nylon brush (diameter about 5mm) for 20 times. From 1 week before tracheotomy to 9 days after tracheotomy, the rabbits in each group were treated with the above drugs. Blood samples were collected on the 10th day after operation, and (BALF) samples from alveolar lavage fluid were collected. The concentrations of interleukin-6 (IL-8), transforming growth factor 尾 1 (TGF- 尾 1) and vascular endothelial growth factor (VEGF) (VEGF) in serum and BALF fluid of rabbits were detected by enzyme linked immunosorbent assay (ELISA). The trachea was taken to measure the degree of trachea stenosis. Results the concentrations of IL-8 in serum and BALF of each experimental group (EM,EM PG,EM BS,EM PG BS group) treated with low dose erythromycin were significantly lower than those of NS,PG,BS group (P 0.05) and NS,PG,BS group (P 0.05). There was no significant difference between the two groups (P0.05), and there was no significant difference between the two groups in EM,EM PG,EM BS (P0.05). In 42 rabbits, there were different degrees of granulomatous tissue proliferation resulting in tracheal stenosis. The tracheal stenosis was caused by granulation tissue proliferation in 42 rabbits. The degree of stenosis in EM,EM PG,EM BS,EM PG BS group was (53.3 卤4.4)%, (48.2 卤5.0)%, (24.3 卤4.4)%, (29.5 卤3.2)%, (47.8 卤6.5)%, (27.9 卤3.1)%, (15.6 卤2.0)%, respectively. The difference was statistically significant (P0.05) in); EM PG BS group, the degree of stenosis was significantly lighter than that in other groups, and the difference was statistically significant (P0.05). Conclusion low dose erythromycin can effectively inhibit the excessive proliferation of granulation tissue after tracheal injury, reduce the degree of tracheal stenosis after tracheal injury and the rate of restenosis after tracheal stenosis treatment. Combination with other antibiotics and glucocorticoids may have potential clinical value in the prevention and treatment of benign proliferative tracheal stenosis.
【学位授予单位】：广西医科大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R562.1

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