摘要： 目的 探究胃食管反流在常氧和慢性间歇低氧（CIH）条件下对大鼠呼吸系统的影响。方法 将40只大鼠随机分成常氧组（Norm组）和CIH组，各组均分别予以生理盐水（NS）和盐酸（HCl）灌注。于灌注前1 d和灌注第7、14、21天，采集增强呼气间歇（Penh）值评价气道反应性。末次灌注后计数支气管肺泡灌洗液（BALF）细胞，检测血清和BALF嗜中性粒细胞趋化因子1（CXCL1）和C反应蛋白（CRP）水平。结果 与Norm+NS组比，Norm＋HCl组Penh值、气道对乙酰甲胆碱（MCh）反应性以及BALF细胞总数、中性粒细胞数、淋巴细胞数、CXCL1和CRP水平增高（P<0.05）。与CIH＋Norm组比，CIH＋HCl组Penh值、气道对MCh的反应性、血清CRP水平以及BALF细胞总数、中性粒细胞数、淋巴细胞数、CXCL1、CRP水平增高（P<0.05）。与Norm组比，盐酸灌注后CIH组气道对MCh反应性进一步升高且出现更早，BALF中性粒细胞、淋巴细胞、CXCL1和CRP以及血清CRP水平进一步升高（P<0.05）。结论 盐酸灌注使大鼠出现呼吸系统结构和功能损伤，CIH条件下损伤更重且出现更早。

胃食管反流对慢性间歇低氧大鼠呼吸系统的影响

李佳桐, 刘丹, 孔灵菲, 王玮

中国医科大学附属第一医院呼吸与危重症医学科, 沈阳 110001

收稿日期:2020-06-15出版日期:2021-03-30发布日期:2021-03-20
通讯作者:王玮E-mail:wwbycmu@126.com
作者简介:李佳桐(1993-),女,医师,硕士.
基金资助:国家自然科学基金（81670085）；国家重点研发计划（2016YFC1304502）


关键词: 胃食管反流, 慢性间歇低氧, 气道炎症, 肺损伤
Abstract: Objective To investigate the effects of repeated esophageal hydrochloric acid (HCl) perfusion on the respiratory system under both normoxia (Norm) and chronic intermittent hypoxia (CIH) conditions. Methods Forty Wistar rats were randomly divided into Norm and CIH groups,both of which were perfused with normal saline (NS) or HCl. Enhanced pause (Penh) values were estimated to assess the airway hyperresponsiveness on days 0,7,14,and 21 of perfusion. The number of inflammatory cells in bronchoalveolar lavage fluid (BALF) and the levels of CXC chemokine (CXCL1) and C-reactive protein (CRP) in BALF and sera were determined. Results Penh value and airway hyperresponsiveness to methacholine,and the CXCL1 and CRP levels as well as the neutrophil,lymphocyte,and total cell numbers in BALF significantly increased (P<0.05) in Norm + HCl group compared with Norm + NS group. The same parameters and serum CRP level significantly increased (P<0.05) in CIH + HCl group compared with CIH + NS group. In CIH group,airway hyperresponsiveness,the numbers of neutrophils and lymphocytes and the levels of CXCL1 and CRP in BALF,and serum CRP level significantly increased after HCl perfusion (P<0.05) compared with the values in Norm group. Conclusion HCl perfusion causes respiratory injury,which is exacerbated and accelerated by CIH.
Key words: gastroesophageal reflux, chronic intermittent hypoxia, airway inflammation, lung injury
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