P-选择素在肠缺血再灌注致大鼠多器官损伤中的表达及意义  

Expression and significance of P-selectin in multiple organ dysfunction induced by intestinal ischemia reperfusion

作　　者：王兴东[1] 顾志成[2] 孙庆林[2] 刘维明[2] 季正华[1] 朱雪明[1] 张志德[3] 

机构地区：[1]苏州大学附属儿童医院儿科研究所,215003 [2]苏州大学附属儿童医院外科,215003 [3]苏州大学附属第一医院外科

出　　处：《中华创伤杂志》2007年第3期231-234,共4页Chinese Journal of Trauma

摘　　要：目的探讨肠缺血再灌注损伤时肠、肝、肺组织P-选择素蛋白的表达及意义。方法24只大鼠随机分成4组，每组6只。分别为假手术组和缺血40min／再灌注30min、再灌注60min、再灌注240min4组。夹闭肠系膜上动脉制作大鼠肠缺血再灌注模型，应用免疫组织化学的方法观察小肠P-选择素表达的变化，同时检测肠、肝、肺组织及血清髓过氧化物酶（MPO）活性的变化。结果假手术组肠、肝、肺组织中P一选择素为低表达，肠缺血再灌注后各组可见P-选择素不同程度表达明显增高，细胞染色阳性细胞数明显高于假手术组，其灰度值水平明显提高，为假手术组的2倍左右（P〈0．01）。血MPO活性假手术组为（46．16±6．19）U／L，再灌注30min达高峰（148．83±22．80）U／L（P〈0．01）。与假手术组比较，再灌注各组肠、肝、肺组织MPO活性都有明显增高（P〈0．01），各组在缺血40min／再灌注60min时增加幅度最大。血清丙氨酸转氨酶活性在肠缺血再灌注后各组都有明显升高（P〈0．01）。结论（1）肠缺血再灌注可导致肠、肝、肺组织P-选择素表达的早期上调，P-选择素在肠缺血再灌注导致肠及远隔脏器肝和肺组织损伤的过程中发挥重要作用。（2）肠缺血再灌注不仅引起肠组织本身损伤，还引起远隔脏器肝和肺的炎症和损伤。Objective To investigate the expression and significance of P - selectin protein in tissues of intestine, liver and lung following intestinal ischemia reperfusion injury. Methods Twenty - four rats were divided into four groups （ n = 6 in each group） ： the sham group, the ischemia for 40 minutes/ reperfusiun for 30 minutes （ 1 40 min/R 30 min ）group, the 1 40 min/R 60 min group and the 1 40 min/R 240 vain group. Rat intestinal ischemia reperfusion models were made by clamping the superior mesenteric artery （SMA）. The levels of P-selectin were assayed with immunohistochemistry and the myeloperoxidase （MPO） activities of the intestine, liver and lung were determined as well. Results The sham group showed low expression of P-selectin in the intestinal, liver and lung tissues. The I/R experimental groups showed higher expression of P - selectrin based on the number and gray value of the positive cells （P 〈 0.01 ）. The MPO activity in blood peaked at 30 minutes after reperfusion （ 148.83 ± 22.80） U/L and its level in the sham group was （46. 16 ±6. 19） U/L （P 〈0.01 ）. Compared with the sham group, the MPO activity in the intestinal, liver and lung tissues increased obviously in the three I/R groups after intestinal ischemia and reperfusion and their peak values were found in the 1 40 min/R 60 min group. The serum alanine transaminase activity increased markedly in the I/R groups （P〈0.01）. Conclusion 1. Intestinal I/R may lead to early up-regulation of P-selectin in the intestinal, liver and lung tissues. P-selectin plays an important role during the course of intestinal, liver and lung injuries induced- intestinal I/R. 2. Injury is not only in intestine but also in the distant organs like liver and lung following intestinal I/R.

关 键 词：再灌注损伤 过氧化物酶 肠 P-选择素 

分 类 号：R686[医药卫生—骨科学]