从溃疡性结肠炎大鼠肺损伤看“肺与大肠相表里”的特异性

目的观察溃疡性结肠炎（ulcerative colitis，UC）大鼠肺支气管病损特点及肺肠相关的特异性，为“肠病及肺”理论提供依据。方法采用家兔结肠黏膜组织致敏与三硝基苯磺酸（TNBS）－乙醇模型相结合的免疫复合法复制UC大鼠模型，并与正常大鼠对照。检测两组大鼠肺功能［吸气阻力（Ri）、呼气阻力（Re）、用力肺活量（FVC）、0.2秒率（FEV0.2/FVC）、最大通气量（MVV）和平均用力呼气流速（FEF25%－75%）］及肝肾功能［血清丙氨酸氨基转移酶（ALT）、天门冬氨酸氨基转移酶（AST）、尿素氮（BUN）和肌酐（Cr）］；观察两组结肠、肺、肝、肾病理改变。结果模型组大鼠急、慢性期均表现为体重下降，黏液便、稀便，部分大鼠出现呼吸困难，气促、喘鸣等症状。与正常组比较，模型组大鼠急性期MVV、FVC、FEV0.2和FEF25%－75%以及慢性期Ri、Re、MVV、FVC和FEF25%－75%均显著降低（P<0.05，P<0.01），FEV0.2/FVC显著升高（P<0.05），且病理显示有间质性肺炎及肺间质纤维化改变。两组肝肾功能均在正常范围，肝肾组织病理观察未见明显病变。结论 UC可以特异性引起肺支气管病损，肺损伤是UC的肠外表现之一，并从“肠病及肺”角度论证了肺与大肠相表里理论。

英文摘要:

Objective To observe the features of bronchopulmonary lesions in ulcerative colitis （UC） rats and the specificity with Fei and Dachang， thus providing reliance for the theory of “intestinal diseases involved Fei”. Methods The UC rat model was duplicated by using rabbit intestine mucosa tissue allergenic model and TNBS ethanol model. A normal rat group was set up as the control. The pulmonary functions ［including inspiratory resistance （Ri）， expiratory resistance （Re）， forced vital capacity （FVC）， FEV0.2/FVC， maximal voluntary ventilation （MVV）， forced expiratory flow rate （FEF25%－75%）］， and indicators of liver and kidney functions ［serum alanine aminotransferase （ALT）， aspartate amino transferase （AST）， blood urea nitrogen （BUN）， and creatinine （Cr）］ were detected in the two groups. The pathological changes of colon， lung， liver， and kidney were observed in the two groups. Results Rats in the model group in both acute and chronic stages had weight loss， mucus and loose stool. Partial rats had such symptoms as dyspnea， shortness of breath， and wheezing. Compared with the normal group， the MVV， FVC， FEV0.2 and FEF25%－75% in the acute stage； Ri， Re， MVV， FVC， and FEF25%－75% in the chronic stage all significantly decreased （P<0.05， P<0.01）， and FEV0.2/FVC significantly increased in the model group （P<0.05）. The pathological results showed interstitial pneumonia and pulmonary interstitial fibrosis in the model group. But the indicators of liver and kidney functions were all in the normal range. No obvious pathological change was seen in the renal and liver tissues in the two groups. Conclusions UC could specifically induce bronchopulmonary lesions. Lung injury was one of UC′s intestinal manifestations. The theory of “Fei and Dachang being interior exteriorly correlated” was demonstrated from the theory of “intestinal diseases involved Fei”.

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