[The effects of three dosages of nebulized unfractionated heparin on alveolar coagulation and tissue inflammation injury in endotoxin-induced acute lung injury rat model].

Zong-yu Wang, Sheng-nan Wu, Xi Zhu
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Abstract

Objective: To observe the effects of three dosages of nebulized unfractionated heparin (UFH) on alveolar coagulation, inflammation and lung histology in endotoxin-induced acute lung injury rat model, and investigate the appropriated dose of local UFH in managing intrapulmonary coagulopathy.

Methods: Twenty-nine male Wistar rats were divided into control (n=5) and UFH group (n=24) in table of random number, which were duplicated to be endotoxin-induced ALI rat model with lipopolysaccharide (LPS) injecting by intravenous route. The UFH group was divided into three subgroups, which were administered once with 6, 12 and 18 U/g aerosolized UFH in 10 ml at 2 hours after challenge, respectively, while the control group was simply nebulized with normal saline. All rats were sacrificed at 6 hours after intravenous administration of LPS, bronchoalveolar lavage was performed, and the fluid was collected. Enzyme-linked immune sorbent assay (ELISA) was used to measure the level of thrombin-antithrombin complex (TATc), tumor necrosis factor-α (TNF-α) in bronchoalveolar lavage fluid (BALF), and lung wet/dry (W/D) weight ratio, histology score were recorded.

Results: At 6 hours after LPS-induced lung injury, the levels of TATc and TNF-α, lung W/D weight ratio and histology score in 6 U/g and 12 U/g group were all lower than those of control group significantly (TATc: 0.959±0.681 μg/L, 1.165±0.854 μg/L vs. 2.141±0.791 μg/L, TNF-α: 4.449±5.054 ng/L, 9.096±4.099 ng/L vs. 18.184±3.869 ng/L, W/D weight ratio: 7.018±1.137, 7.367±0.349 vs. 8.472±0.614, histology score: 16.0±1.0, 16.5±1.5 vs. 19.6±0.4, P<0.05 or P<0.01). There was no significant difference in the comparisons between the subgroups of UFH in TATc level in BALF and lung histology score. For the TNF-αlevel in BALF, 18 U/g group evidently exceeded that of 6 U/g group (15.503±8.753 ng/L vs. 4.449±5.054 ng/L, P<0.01), and lung W/D weight ratio in 18 U/g group was also significantly higher comparing to 6 U/g (8.850±1.157 vs. 7.018±1.137, P<0.05) and 12 U/g group (8.850±1.157 vs. 7.367±0.349, P<0.05).

Conclusion: It was appropriate for the dose of nebulized UFH to be administered no more than 12 U/g in ALI treatment, which was enough to inhibit alveolar coagulant cascade, decrease early inflammatory response and alleviate lung tissue injury.

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[三种剂量未分离肝素雾化对内毒素致急性肺损伤模型大鼠肺泡凝固及组织炎症损伤的影响]。
目的:观察三种剂量未分离肝素雾化对内毒素致急性肺损伤大鼠肺泡凝血、炎症及肺组织学的影响,探讨局部未分离肝素治疗肺内凝血病的适宜剂量。方法:29只雄性Wistar大鼠按随机数字表法分为对照组(n=5)和UFH组(n=24),经静脉注射脂多糖(LPS)复制内毒素诱导的ALI大鼠模型。将UFH组分为3个亚组,攻毒后2小时,分别以6、12、18 U/g的UFH雾化10 ml给药一次,对照组简单用生理盐水雾化。所有大鼠于静脉注射LPS后6小时处死,行支气管肺泡灌洗,收集积液。采用酶联免疫吸附试验(ELISA)测定大鼠支气管肺泡灌洗液(BALF)中凝血酶-抗凝血酶复合物(TATc)、肿瘤坏死因子-α (TNF-α)水平,肺湿/干(W/D)重量比,记录组织学评分。结果:lps诱导肺损伤后6 h, 6 U/g组和12 U/g组大鼠的TATc、TNF-α水平、肺W/D重量比和组织学评分均显著低于对照组(TATc: 0.959±0.681 μg/L、1.165±0.854 μg/L比2.141±0.791 μg/L, TNF-α: 4.449±5.054 ng/L、9.096±4.099 ng/L比18.184±3.869 ng/L, W/D重量比:7.018±1.137、7.367±0.349比8.472±0.614,组织学评分:16.0±1.0、16.5±1.5比19.6±0.4,p)。在ALI治疗中,雾化UFH的剂量以不超过12u /g为宜,足以抑制肺泡凝血级联,降低早期炎症反应,减轻肺组织损伤。
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