目的 建立间歇低氧(IH)-肺气肿大鼠模型,探讨其引起炎症和免疫反应的特点.方法 60只Wistar大鼠随机分成对照组、肺气肿组、IH组和重叠组(肺气肿合并IH组).每组15只.造模成功后使用流式细胞仪测定各组外周血中性粒细胞(PMN)、CD3+CD8+T细胞、CD3+CD4+T细胞凋亡率水平.酶联免疫吸附试验(ELISA)法测定血浆中肿瘤坏死因子(TNF)-α、白细胞介素(IL)-6水平.取大鼠肺泡灌洗液(BALF),在光镜下计算巨噬细胞、外周血PMN和淋巴细胞比例.采集肺、肝脏、胰腺组织和右颈动脉并进行病理评分.结果 重叠组中PMN、CD3+CD8+T细胞凋亡率与其他3组相比较低,CD3+CD4+T细胞凋亡率、TNF-α、IL-6表达水平最高(均P<0.05).BALF中,肺气肿组巨噬细胞和PMN百分比高于其余3组(均P<0.05).重叠组中肺、肝脏、胰腺、右颈动脉内中膜厚度的病理评分高于其他3组(均P<0.05).结论 肺气肿合并IH可产生更严重的系统性多器官炎症和免疫反应.%Objective To develop an"overlap syndrome (OS)"rat model by intermittent hypoxia (IH) exposure on the base of pre-existing emphysema, and to explore its characters of severe systemic inflammation and immune responses. Methods Sixty Wistar rats were put into four groups:control group, IH group, emphysema group and overlap (emphysema+IH) group. The peripheral blood samples were collected for detecting apoptosis of CD3+CD4+,CD3+CD8+T lymphocytes and neutrophils (PMN). Tumor necrosis factor (TNF)-αand interleukin (IL)-6 were evaluated by ELISA. The bronchoalveolar la-vage fluid (BALF) was taken to calculate the ratio of macrophages, neutrophils and lymphocytes under light microscope. Tis-sue blocks of lung, liver, pancreas, and right carotid artery were taken for pathologic scoring. Results The apoptotic rates of PMN and CD3 +CD8 +T cells were significantly lower in overlap group than those of other three groups (P<0.05). Pro-in-flammatory factor IL-6, TNF-αand peripheral blood CD3 +CD4 +T cell apoptosis were the highest in overlap group com-pared to those of other three groups (P<0.05). The ratio of PMN and macrophages in BALF were significantly higher in em-physema group than those of other three groups (P<0.05) and the pathology scores of lung, liver, pancreas, the ratio of carot-id artery intima-media thickness of whole thickness of vascular were significantly higher in overlap group than those of other three groups (P < 0.05).Conclusion In rat model of intermittent hypoxia-emphysema there are more serious systemic multi-organ inflammation and immune responses.
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