胸部撞击伤时游离Ca^2+浓度与中性粒细胞凋亡及肺损伤的关系  

Polymorphonuclear neutrophil apoptosis and its role in the lung injury after chest impact trauma

作　　者：刘韧[1] 肖南[1] 田昆仑[1] 刁有芳[1] 

机构地区：[1]第三军医大学大坪医院野战外科研究所,重庆400042

出　　处：《中国危重病急救医学》2002年第2期83-86,共4页Chinese Critical Care Medicine

摘　　要：目的 :动态观察兔胸部撞击伤时中性粒细胞 (PMN)凋亡的发生以及与肺损伤之间的关系。方法 :制备兔胸部撞击伤模型 ,分离纯化肺灌洗液中的 PMN,应用流式细胞术测定 PMN凋亡、坏死、存活细胞比例及呼吸爆发功能的变化 ,并且观察与乳酸脱氢酶 (L DH)和胞浆游离 Ca2 +变化之间的关系。结果 :肺灌洗液中PMN的凋亡延迟持续至 12小时 ,在伤后各时间点活细胞增多 ;而肺灌洗液 PMN呼吸爆发从伤后 2小时即显著增强 ,8小时达到峰值 ;同时肺灌洗液 L DH的升高在伤后 4～ 2 4小时显著高于正常对照组 ;伤后 PMN胞浆游离 Ca2 +有短暂升高。结论 :胸部撞击伤时 ,PMN在肺组织中大量扣押 ,且正常的凋亡途径发生障碍 ,造成PMN持续处于激活状态及毒性内容物的持续释放 ,与肺组织损伤有密切关系 ,并且 PMN凋亡延迟可能与胞浆游离 Ca2Objective:To investigate the relationship between the regulation of polymorphonuclear neutrophil (PMN) apoptosis and the lung injury after chest impact trauma.Methods:The rabbits were subjected to chest impact trauma.PMNs were purified from bronchoalveolar lavage fluid and their apoptosis,necrosis,survival and respiratory burst were detected by flow cytometry.Meanwhile,lactate dehydrogenase(LDH) and intracellula free Ca 2+ levels in PMN were also measured.Results:The delayed apoptosis of PMNs in bronchoalveolar lavage fluid was observed from 2 hours to 12 hours after trauma,and the number of viable cells increased.Respiratory burst of PMNs in bronchoalveolar lavage fluid was significantly increased at 2 hours and peaked at 8 hours after trauma.Meanwhile,LDH levels in bronchoalveolar lavage fluid were higher compared with controls from 4 hours to 24 hours ( P <0 05 or P <0 01),while intracellular free Ca 2+ in PMN was increased temporally.Conclusions:Retention of PMN in tissues and the abnormality in apoptotic pathway might result in persistent activation of PMN and excessive release of toxic substances,thereby contributing to tissue injury.The temporal elevation of intracellular free Ca 2+ could be responsible for the delayed apoptosis of PMN.

关 键 词：胸部撞击伤 中性粒细胞 凋亡 呼吸爆发 继发性肺损伤 

分 类 号：R655[医药卫生—外科学]