中性粒细胞凋亡对急性胰腺炎相关性肺损伤的影响  

The role of polymorphonuclear cell apoptosis in pancreatitis-associated lung injury

作　　者：余康敏[1] 王春友[2] 陈鑫[2] 

机构地区：[1]安徽医科大学第一附属医院普外科,安徽省合肥230022 [2]华中科技大学同济医学院附属协和医院胰腺外科中心

出　　处：《中华急诊医学杂志》2005年第9期742-745,共4页Chinese Journal of Emergency Medicine

摘　　要：目的研究中性粒细胞(PMN)在急性胰腺炎相关性肺损伤(PALI)中自发性凋亡的变化及与肺损伤的相关性,探讨PMN凋亡在这一过程中的病理意义。方法采用5%牛磺胆酸钠(TAC)逆行胆胰管注射造成大鼠急性出血坏死性胰腺炎(AHNP)模型。将36只实验动物随机分为AHNP组、假手术组及地塞米松(DXM)治疗组,3h后处死动物。从支气管肺泡灌洗液分离PMN,在体外分别孵育1、3、6h后,以AnnexinV/PI双染色法测定其自发性凋亡率。取肺组织测定肺湿/干比值、髓过氧化物酶(MPO)含量及肺通透性指数,研究自发性凋亡率与肺损伤之间的相关性。结果三组大鼠支气管肺泡灌洗液PMN的自发性凋亡率随体外孵育时间的延长而逐渐增加;在3、6h时,AHNP组均低于假手术组及DXM治疗组,而肺温/干比值、MPO含量及肺通透性指数则高于后两组。AHNP组3h凋亡率与肺温/干比值、MPO含量及肺通透性指数呈负相关。结论肺PMN凋亡减低与PALI大鼠模型肺损伤成负相关,同时伴有活性增强,是PALI发生的重要原因;DXM可减轻PALI,与其促进PMN凋亡。Objective To investigate the effects of polymorphonuclear （PMN） apeptosis on pancreatitis-associated lung injury （PALl）. Methods Acute hemorrhagic necrotizing pancreatitis （AHNP） model was established by retrograde infusion of 5% sodium taurocholate the into bilio-pancreatic duct in 36 rats. The rats were randomly divided into AHNP group, sham-operation group, dexamethasone （PZM） treatment group, and were killed at 3 hours after operation. PMNs were collected from bronchoalveolar lavages, and the spontaneous apeptosis in vitro were evaluated at 1, 3, and 6 hours after incubation. Pulmonary injury was evaluated through ratio of wet to dry weight, myeloperoxidase （MPO） activity and lung permeability index. Results The apeptosis of PMNs from BALFs increased with incubation time in vitro in the three groups. The apeptosis percentage in AHNP group were less than that in sham-operation group and in DXM-treatment group at 3 and 6 hours after incubation. However the wet to dry ratio, MPO activity and lung permeability index were higher. The apeptosis rate at 3 hours was correlated inversely with wet to dry ratio, MPO activity and lung permeability index in the AHNP rats. Conclusion Apeptosis of PMNs correlated reversely with lung injury, playing an important role in pathogenesis of PALl. DXM can reduce lung injury because of its capability to promote PMNs apeptosis and inhibit their activities.

关 键 词：急性胰腺炎相关性肺损伤 中性粒细胞 凋亡 中性粒细胞凋亡 急性胰腺炎 肺损伤 支气管肺泡灌洗液 急性出血坏死性胰腺炎 PMN凋亡 自发性凋亡 

分 类 号：R657.51[医药卫生—外科学]