中性粒细胞和内皮细胞凋亡及相关因子改变在晚期创伤性脓毒症发病中的作用  

Role of apoptosis of neutrophils and vascular endothelial cells and changes of relative factors in the pathogenesis of traumatic sepsis at the advanced stage

作　　者：魏宇淼[1] 廖玉华[1] 褚淑娟[2] 周全军[2] 王国荣[3] 王朝晖[1] 程龙献[1] 

机构地区：[1]华中科技大学同济医学院附属协和医院心内科,武汉430022 [2]华中科技大学同济医学院附属协和医院重症监护病房,武汉430022 [3]华中科技大学同济医学院附属协和医院综合科,武汉430022

出　　处：《中华创伤杂志》2006年第9期686-689,共4页Chinese Journal of Trauma

基　　金：国家自然科学基金(30300133)

摘　　要：目的探讨中性粒细胞及内皮细胞凋亡及相关细胞因子和凝血因子改变是否参与晚期创伤性脓毒症的发病。方法收集晚期创伤性脓毒症患者外周血,分离培养外周血单个核细胞(PBMC)及中性粒细胞,观察创伤性脓毒症患者中性粒细胞和内皮细胞凋亡情况,并检测PBMC培养上清白细胞介素(IL)-4、IL-10以及外周血组织因子(TF)、血管性血友病因子(vWF)的水平,比较晚期创伤性脓毒症组与对照组的差异。结果晚期创伤性脓毒症组中性粒细胞凋亡水平[(37±21)%]和循环内皮细胞凋亡[(774±211)个/ml]水平显著高于非脓毒症创伤组[(16±9)%,(92±72)个/ml]和正常对照组。晚期创伤性脓毒症组抗炎细胞因子(IL-4、IL-10)及凝血因子(TF、vwF)水平显著高于对照组。结论晚期创伤性脓毒症患者存在免疫功能抑制和凝血功能异常,这可能是晚期创伤性脓毒症的特征之一,并可能是晚期创伤性脓毒症多脏器功能障碍发生的重要机制。Objective To explore the role of apoptosis of neutrophils and vascular endothelial cells and changes of relative cytokines and thrombotic factors in the pathogenesis of traumatic sepsis at the advanced stage. Methods The venous blood was collected from the patients with traumatic sepsis at advanced stage and traumatic patients without sepsis and healthy subjects. The peripheral blood mononuclear cells （ PBMC ） and neutrophils were isolated and cultured. The apoptosis of neutrophils and vascular endothelial cells was assayed, and the level of IL-4 ,IL- 10 in PBMC culture supernatants were determined, and the tissue factor （TF） and vW factor （vWF） of peripheral plasma were measured. Results The percentages of apoptosis of neutrophils and numbers of apoptotic circulating vascular endothelial cells were higher than that of traumatic patients without sepsis and healthy controls significantly. And the levels of anti -inflammatory cytokines IL- 4, IL - 10 and thrombotic factors TF, vWF in traumatic sepsis were elevated than that of traumatic patients without sepsis and controls too. Conclusion Immune suppression and abnormal thrombotic state may be one characteristic of traumatic sepsis at advanced stage, which perhaps involveds in the pathogenesis of traumatic sepsis at the advanced stage and multiple organ dysfunction syndrome.

关 键 词：脓毒症 中性粒细胞 内皮细胞 细胞凋亡 

分 类 号：R631[医药卫生—外科学]