性别对大鼠创伤失血性休克后循环血多形核白细胞反应的影响  

The Effect of Gender to Circulating Poly-morphonuclear Cell Response after Trauma-hemorrhage Shock

作　　者：朱志宏[1] 沈洪[1] 李冰[1] 田万管[1] 

机构地区：[1]中国人民解放军总医院急诊科,北京市100853

出　　处：《中国全科医学》2007年第6期456-458,共3页Chinese General Practice

摘　　要：目的观察性别对大鼠创伤失血性休克后循环血多形核白细胞(PMN)活化和凋亡的影响。方法实验动物为发情前期的雌性和成年雄性SD大鼠,共30只,分为雄性,雌性和对照3组。麻醉后先在腹部正中做5cm切口造成软组织损伤,分层缝合后通过放血的方法将平均动脉压降至(35±5)mmHg,并维持60min,然后在60min内用4倍于最大失血量的乳酸林格液进行复苏。对照组不进行休克及液体复苏。复苏或假手术后2h和24h分别测定循环血PMN释放过氧化物阴离子和弹性蛋白酶的水平,并用流式细胞仪测定PMN的Fas表达率。结果(1)使用十四烷酰佛波醇乙酰(PMA)刺激后,雄性组和雌性组大鼠复苏后2h、24h时循环血PMN所产生的过氧化物阴离子量与雄性和雌性对照组大鼠相比差异均无显著性意义(P>0.05)。(2)复苏后2h、24h时,雄性组大鼠与雌性组大鼠用N-甲酰-甲硫氨酰-亮氨酰-苯丙氨酸(fMLP)刺激所产生的过氧化物阴离子和用脂多糖(LPS)刺激所产生的弹性蛋白酶水平间差异均有显著性意义(P<0.05)。(3)复苏后2h、24h时,雄性组大鼠PMN的Fas表达率与对照组相比差异均有显著性意义(P<0.01);虽然雌性组Fas表达率也较对照组降低(P<0.05),却明显高于雄性组(P<0.05)。结论创伤失血性休克后雄性大鼠PMN的活化明显高于雌性;雄性大鼠PMN的凋亡较雌性出现延迟。Objective To explore the effect of gender to the activation and apoptosis of circulating poly - morphonuclear cell response after trauma - hemorrhage shock. Methods 30 proestrus female and adult male Sprague - Dawley rats were divided into three groups, female, male and contrast. After anaesthesia, a 5 - centimeter midline laparotomy was made, the wound were closed in layers, then the rats were bled to a mean arterial pressure （MAP） of （35±5） mm Hg for 60 min, and then the rats were resuscitated with four times the volume of withdrawn blood with Ringer＇s lactate over 60 minuts. The contrast group underwent no shock and no treatment. 2 hours and 24 hours after resuscitation, the level of superoxide （ O2^- ） and elastase released by circulating poly - morphonuclear cell were assessed, the Fas expression of poly - morphonuclear cell was measured by flow cytometry. Results （ 1 ） There was no significant difference in the levels of O2^- between female and male groups after the phorbol- 13 -myristate- 12 -acetate （PMA） stimulation and 2 hours and 24 hours after resuscitation （ P 〉 0. 05 ）. （2） 2 hours and 24 hours after resuscitation, there were significant difference in the level of O2^- stimulated by N - formylmethionyl - leucyl phenylalanine （fMLP） and the elastase level stidimulated by lipopolysaccharide （LPS） between female and male groups （ P 〈 0.05 ）. （3） 2 hours and 24 hours after resuscitation, there was significant difference in the level of Fas expression between poly - morphonuclear cell in male group and contrast group （ P 〈 0. 01 ）, although the Fas expression of poly - morphonuclear was also depressed in female rats （ P 〈 0. 05 ）, it was also higher than that of male group （ P 〈 0.05 ）. Conclusion After trauma - hemorrhagic shock, poly - morphonuclear cell activation in male rats was higher than that of proestrus female rats. The poly - morphonuclear cell apoptosis of male rats was delayed compared with female rats.

关 键 词：休克 创伤性 性别 多形核白细胞 细胞凋亡 

分 类 号：R541.64[医药卫生—心血管疾病]