组织因子凝血酶受体和血栓调节蛋白在重度脓毒症诱导ALI／ARDS大鼠肺组织细胞中的表达  

Expression of tissue factor, thrombin receptor and thrombomodulin protein in the lung of rats with severe sepsis - induced ALI/ARDS

作　　者：杨春辉[1] 王璐[1] 薛杨勇[1] 谢娟[1] 徐丹[1] 黄力鸥[1] 吴春荣[1] 唐建国[1] 

机构地区：[1]复旦大学附属上海市第五人民医院创伤-急诊-危重医学部,上海200240

出　　处：《中国急救医学》2012年第11期1012-1014,共3页Chinese Journal of Critical Care Medicine

摘　　要：目的探讨重度脓毒症诱导的ALI/ARDS大鼠肺组织细胞组织因子（TF）、凝血酶受体（TR）和血栓调节蛋白（TM）的表达。方法应用盲肠结扎穿孔（CLP）加生理盐水灌洗法制作重度脓毒症诱导的ALI／ARDS大鼠，以PaO2／FiO2≤300作为ALI/ARDS大鼠纳入标准，随机分为假手术组、ALI／ARDS组。制模成功后1、2、3h处死大鼠，取肺组织称质量制备组织匀浆，ELISA方法测定TF、TR和TM的表达。结果①TF表达：ALI/ARDS组灌洗后1、2、3h分别为（206363±8178）pg／mL、（148186±6383）pg／mL、（170889±7180）pg／mL，较假手术组[（55956±271）pg／mL、（53269±473）pg/mL、（54175±416）pg/mL]明显升高（P〈0．05）。②TR表达：ALI/ARDS组灌洗后1、2、3h分别为（1．657±0．063）ng／mL、（1．180±0．074）ng／mL、（1．497±0．087）ng／mL，较假手术组[（0．266±0．046）ng/mL、（0．273±0．048）ng／mL、（0．258±0．050）ng／mL]明显升高（P〈0．01）。③TM表达：ALI/ARDS组灌洗后1、2、3h分别为（16960±179）ng/mL、（10372±300）ng／mL、（12287±189）ng／mL，较假手术组[（567±21）ng／mL、（774±35）ng／mL、（695±43）ng/mL]明显升高（P〈0．05）。ALI／ARDS组组内各时点参数比较差异无统计学意义，但呈现灌洗后1h急性应激性升高、2h后下降、3h后再次上升的趋势。结论重度脓毒症诱导的ALI/ARDS大鼠肺组织在高表达TF和TR等促凝血因子的同时，也高表达具有辅助抗凝和增加纤溶功能的TM。Objective To investigate the expression of tissue factor （TF）, thrombin receptor （TR） and thrombomodulin protein （TM） in severe sepsis -induced ALI/ARDS rats＇ lung. Methods Severe sepsis - induced ALI/ARDS rats were made by cecal ligation and puncture plus normal saline lavage, and PaO2/FiO2 ≤ 300 was taken as inclusion criteria. Rats were randomly divided into sham operation group, ALI/ARDS group. Rats were sacrificed at 1, 2, 3 h after models were made, lung tissues were prepared for homogenates after tissue weighing. Concentration of tissue factor （TF）, thrombin receptor （TR） and thrombomodulin protein （TM） were detected by ELISA method. Results （1）expression of TF： expression of TF was higher in ALI/ARDS group [ （206 363±8178） pg/mL, （148 186 ± 6383） pg/mL,（170 889 ± 7180） pg/mL] than in sham operation group [ （55 956 ± 271） pg/mL,（53 269 ± 473） pg/mL,（54175 ± 416） pg/mL] （P 〈0.05）. （2） expression of TR： expression of TR was higher in ALI/ARDS group [ （ 1. 657 ± 0.063 ） ng/mL, （ 1. 180 ± 0.074） ng/ mL, （1.497 ± 0.087） ng/mL] than in sham operation group [ （0.266 ± 0.046） ng/mL, （0.273 ±0.048） ng/mL, （0.258 ± 0.050） ng/mL] （P 〈0.05）. （3） expression of TM： expression of TM was higher in ALI/ARDS group [ （16 960 ± 179） ng/mL, （10 372 ± 300） ng/mL, （12 287 ± 189） ng/mL] than in sham operation group [ （567 ± 21） ng/mL, （774 ± 35） ng/mL, （695 ± 43） ng/ mL] （P 〈 0.05）. Expression of TF,TR,TM in ALI/ARDS group showed stress -induced increase after 1 - hour lavage, and decreased 2 h later and then rose again 3 h later. Conclusion High expression of TM is able to improve auxiliary anticoagulant and fibrinolytic function as well as the high expression of TF and TR in ALI/ARDS induced by severe sepsis combined with secondary attack. Expression of TF, TR, TM in ALI/ARDS induced by severe sepsis combined with secondary attack showed stress - induced increase, followed by

关 键 词：重度脓毒症 急性肺损伤 急性呼吸窘迫综合征(ALI ARDS) 组织因子(TF) 凝血酶受体(TR) 血栓调节蛋白(TM) 

分 类 号：R641.06[医药卫生—外科学]