贵州医科大学学报

2020, v.45;No.237(06) 638-642+667

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呼吸机相关性肺损伤小鼠血清EMPs和NGAL的变化及意义
Changes and Significance of Mouse Serum EMPs and NGAL in Ventilator-Induced Lung Injury

何丙寅;周强;段鹏;杨震;
HE Bingyin;ZHOU Qiang;DUAN Peng;YANG Zhen;Department of Anesthesiology,Wuhan Jinyintan Hospital;Department of Obstetrics and Gynecology,Xiangyang No.1 Renmin Hospital;

摘要(Abstract):

目的:研究小鼠血清内皮细胞微粒(EMPs)、中性粒细胞明胶酶相关脂质运载蛋白(NGAL)水平对呼吸机相关性肺损伤(VILI)的预测价值。方法:40只SPF级昆明种小鼠均分为高吸气末峰压组、低吸气末峰压组、大潮气量组、小潮气量组及对照组,分别采用相应的机械通气(MV)策略构建急性VILI模型,对照组小鼠仅切开气管;造模通气2 h时,比较5组小鼠血清EMPs、NGAL水平,采用Pearson法分析EMPs、NGAL的相关性;观察4组MV模型小鼠肺损伤程度,采用受试者工作特征曲线(ROC曲线)下面积(AUC)评价EMPs、NGAL对重度肺损伤的预测价值。结果:造模通气2 h时,5组小鼠血清EMPs、NGAL水平比较,高吸气末峰压组>低吸气末峰压组>大潮气量组及小潮气量组,差异有统计学意义(P <0. 05); Pearson相关性分析结果显示,EMPs与NGAL有正相关关系(r=0. 515,P=0. 003); 4组MV小鼠肺损伤程度比较,差异有统计学意义(P <0. 05),轻度肺损伤、中度肺损伤小鼠血清EMPs水平低于重度肺损伤小鼠,差异有统计学意义(P <0. 05);轻度肺损伤小鼠血清NGAL水平低于重度肺损伤小鼠,差异有统计学意义(P <0. 05); ROC曲线分析结果显示,EMPs与NGAL联合预测重度肺损伤小鼠价值较高(AUC=0. 910、敏感度为98. 0%、特异度为76. 9%)。结论:EMPs与NGAL有望作为诊断及判断VILI严重程度的生物标志物。
Objective: To investigate the predictive value of the levels of mouse serum endothelial microparticles( EMPs) and neutrophil gelatinase-associated lipocalin( NGAL) in ventilator-induced lung injury( VILI). Methods: Based on different strategies of mechanical ventilation( MV) to establish acute mouse VILI models,forty SPF Kunming mice were divided into high peak inflation pressure( HPIP) group,low peak inflation pressure( LPIP) group,high tidal volume( HTV) group,low tidal volume( LTV) group. Mice were cut trachea open in control group. At 2 hours after establishing acute mouse VILI models,serum were collected to measure the levels of EMPs and NGAL. Pearson correlation analysis was used to analyze the correlation between EMPs and NGAL. The severity of lung injury was observed. The area under ROC curve( AUC) was used to evaluate the accuracy of EMPs and NGAL to predict severity of lung injury. Results: The levels of the serum EMPs and NGAL were ranked in the order of HPIP > LPIP > HTV > LTV( P < 0. 05). Pearson correlation analysis showed that EMPs were positively associated with NGAL( r = 0. 515,P = 0. 003). The severity of the lung injury was statistically different in 4 groups of VILI mice( P < 0. 05). In addition,serum EMPs levels were significantly lower in mice with mild lung injury and moderate lung injury than those in mice with severe lung injury( P < 0. 05). Serum NGAL levels were remarkably lower in mice with mild lung injury than those in mice with severe lung injury( P < 0. 05). ROC curve analysis showed that the combination of EMPs and NGAL to predict severe lung injury mice had high accuracy( AUC =0. 910,sensitivity 98. 0%,the specificity 76. 9%). Conclusion: EMPs and NGAL may be used as biomarkers for diagnosing and judging the severity of VILI.

关键词(KeyWords): 呼吸机相关性肺损伤;内皮细胞微粒;中性粒细胞明胶酶相关脂质运载蛋白;高吸气末峰压;低吸气末峰压;大潮气量;小潮气量
ventilators,mechanica(MV);ventilator-induced lung injury(VILI);endothelial microparticles(EMPs);neutrophil gelatinase-associated lipocalin(NGAL);high peak inflation pressure;low peak inflation pressure;high tidal volume;low tidal volume

Abstract:

Keywords:

基金项目(Foundation): 国家自然科学基金(81901567)

作者(Author): 何丙寅;周强;段鹏;杨震;
HE Bingyin;ZHOU Qiang;DUAN Peng;YANG Zhen;Department of Anesthesiology,Wuhan Jinyintan Hospital;Department of Obstetrics and Gynecology,Xiangyang No.1 Renmin Hospital;

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DOI: 10.19367/j.cnki.2096-8388.2020.06.004

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