| 摘要: |
| ［摘要］ 目的 研究胸科手术机械通气前后血清中脂多糖结合蛋白（LBP）表达的差异，寻求早期诊断呼吸机相关性肺损伤（VALI）的特异性标志物，并作为临床治疗的作用靶点。方法 将入选行开胸肺叶切除手术的20例患者采用随机对照研究方法，将手术部位、术式相同的患者分别纳入双肺通气（TLV）组和单肺通气（OLV）组，每组10例。每例分别在机械通气前(T0)、手术结束时(T1)、术后24 h(T2)和术后48 h(T3)采取静脉血样本，离心取上清液置-80 ℃保存。Western Blot法检测血清中LBP的表达水平。结果 LBP随着时间延长呈不断升高趋势，两组中各时点间LBP表达水平比较差异有统计学意义（P<0.05），但两组间各时点比较差异无统计学意义（P>0.05），组间与时点间存在交互作用，即两组LBP升高的幅度不同，OLV组较TLV组上升幅度大。结论 LBP的表达水平随着机械通气的时长呈升高趋势，OLV升高幅度较TLV大，机械通气会影响LBP的表达水平，LBP可能参与了VLAI的过程。 |
| 关键词: 呼吸机相关性肺损伤 脂多糖结合蛋白 免疫印迹 |
| DOI：10.3969/j.issn.1674-3806.2014.06.05 |
| 分类号:R 614 |
| 基金项目:广西自然科学基金资助项目（编号：桂科自0832232）；广西卫生厅重点科研课题（编号：桂卫重2011079） |
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| Expression of serum lipopolysaccharide binding protein before and after mechanical ventilation in thoracic surgery |
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ZHANG Li-zhen，LI Yang，PENG Dan-hui，et al.
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Department of Critical Care Medicine，Affiliated Tumor Hospital of Guangxi Medical University,Nanning 530021，China
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| Abstract: |
| ［Abstract］ Objective To study the difference between the expression of lipopolysaccharide binding protein(LBP) in serum before and after mechanical ventilation, explore the specific marker in early diagnosis of ventilator-induced lung(VALI) injury and find out the target of clinical treatment.Methods Twenty patients who received radical resection of lung cancer were selected. Every two lung cancer patients with the same surgical sites and methods were divided into the TLV group and the OLV group. Venous blood was collected at the moment before mechanical ventilation(T0), at the end of operation(T1),at 24 h after operation(T2) and at 48 h after operation(T3). After the blood was separated by centrifugation, the supernatant was collected and stored them at -80 ℃. Western blot method was used to measure the LBP expression levels.Results The difference in the two groups was statistically significant at each time point(P<0.05), but the difference between the groups at each time point was not statistically significant(P>0.05), there was an interaction between the groups and each time points.The increased amplitude of LBP was different in the two groups,the OLV group had a bigger rise than the TLV group.Conclusion Mechanical ventilation affects the LBP expression level, and the LBP indeed plays an important role in the VALI. |
| Key words: Ventilator-associated lung injury(VALI) Lipopolysaccharide binding protein(LBP) Western blot method |
