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早期生命期气管内布地奈德对早产胎兔肺成熟度的影响。

Effects of intratracheal budesonide during early postnatal life on lung maturity of premature fetal rabbits.

机构信息

Department of Pediatrics, Xijing Hospital, The Fourth Military Medical University, Xi'an, PR China.

Department of Burns and Cutaneous Surgery, Xijing Hospital, The Fourth Military Medical University, Xi'an, PR China.

出版信息

Pediatr Pulmonol. 2018 Jan;53(1):28-35. doi: 10.1002/ppul.23889. Epub 2017 Oct 13.

Abstract

AIM

This study aimed to study the effects of intratracheal instillation of budesonide on lung maturity of premature fetal rabbits. The developmental pattern of pulmonary alveoli in rabbits is similar to that in humans.

METHOD

Fetal rabbits were taken out from female rabbits on the 28th day of pregnancy (full term = 31 days) by cesarean section (c-section). The fetal rabbits were divided into four groups: control (normal saline, NS), budesonide (budesonide, BUD), calf pulmonary surfactant for injection (pulmonary surfactant, PS), and calf pulmonary surfactant + budesonide for injection (pulmonary surfactant + budesonide, PS + BUD). All premature rabbits were kept warm after c-section. After 15-min autonomous respiration, a tracheal cannula was implemented for instilling NS, BUD, PS, and PS + BUD. The morphology of lung tissues of premature fetal rabbits was analyzed using optical and electron microscopes. Surfactant protein B (SP-B) mRNA and protein levels in lung tissues were determined using polymerase chain reaction and Western blotting, respectively.

RESULT

Intratracheal instillation of BUD could increase the alveolar area of the fetal rabbits (P < 0.01), decrease the alveolar wall thickness (P < 0.01), and increase the mean density of lamellar bodies (P < 0.05) and SP-B protein levels in type II epithelial cells of pulmonary alveoli (P < 0.05).

CONCLUSION

Intratracheal instillation of BUD during early postnatal life is effective in promoting alveolarization and increasing SP-B expression, the pro-pulmonary maturity of BUD combined with PS is superior to that of BUD or PS alone. However, the long-term effect of BUD on lung development needs further exploration.

摘要

目的

本研究旨在探讨经气管内滴入布地奈德对早产胎兔肺成熟度的影响。兔肺的发育模式与人相似。

方法

通过剖宫产术(c-section)从妊娠第 28 天的母兔中取出胎兔(足月=31 天)。将胎兔分为四组:对照组(生理盐水,NS)、布地奈德(布地奈德,BUD)、牛肺表面活性剂注射液(肺表面活性剂,PS)和牛肺表面活性剂+布地奈德注射液(肺表面活性剂+BUD,PS+BUD)。所有早产儿在 c-section 后均保持温暖。自主呼吸 15 分钟后,进行气管插管,分别滴注 NS、BUD、PS 和 PS+BUD。使用光学和电子显微镜分析早产胎兔肺组织的形态。使用聚合酶链反应和 Western blot 分别测定肺组织中表面活性蛋白 B(SP-B)mRNA 和蛋白水平。

结果

经气管内滴注 BUD 可增加胎兔的肺泡面积(P<0.01),降低肺泡壁厚度(P<0.01),并增加肺泡Ⅱ型上皮细胞中板层小体的平均密度(P<0.05)和 SP-B 蛋白水平(P<0.05)。

结论

在出生后早期经气管内滴注 BUD 可有效促进肺泡化,增加 SP-B 表达,BUD 联合 PS 的促肺成熟作用优于单独使用 BUD 或 PS。然而,BUD 对肺发育的长期影响需要进一步探讨。

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