摘要
目的探讨重度创伤-失血性休克大鼠细胞免疫与肠道通透性改变的相关性。方法健康雄性SD大鼠30只随机分为对照组和实验组,实验组折断一侧股骨并将股动脉放血后造成重度创伤-失血性休克,分别于即刻、1、2和3 h为时间点,采集下腔静脉血测定血内毒素、二胺氧化酶、D-乳酸、及淋巴细胞亚群含量,同步切取末端回肠组织做病理切片观察肠黏膜形态学变化。结果重度创伤-失血性休克后随时间延长血内毒素、二胺氧化酶、D-乳酸含量逐渐增高(P<0.05),辅助性T淋巴细胞(CD3^+CD4^+)逐渐降低,抑制性T淋巴细胞(CD3^+CD8^+)逐渐升高,末端回肠绒毛水肿,上皮细胞脱落,炎性细胞浸润等逐渐加重。结论重度创伤-失血性休克后血内毒素、D-乳酸、二胺氧化酶含量与肠壁病理改变呈正相关,而与CD4^+/CD8^+比值呈负相关,但此二者的改变却没有明显先后次序,几乎是同步变化的。由此推断,肠壁通透性的增加和细胞免疫功能的下降都与休克后细胞的缺血缺氧直接相关,而且互为因果。
[ Objective ] To investigate the correlation of cellular immunity and intestinal permeability after severe trauma-hemorrhagic shock in rats. [ Methods ] Thirty healthy adult male SD rats were randomly divided into experimental group and control group. The model of severe trauma-hemorrhagic shock was made in the experimental group, by fracturing the femur bone and bleeding the femoral artery. Then the blood samples were collected from the inferior vena venous at the onset of the shock, 1 h, 2 h and 3 h after the set-up of the shock to determine the endo- toxin, diamine oxidase, D-lactic acid and lymphocyte subsets contents. The pathological changs of the ileum mucosa were observed by HE staining. [Results ] Endotoxin, diamine oxidase, D-lactic acid content increased gradually with the time increasing after severe trauma - hemorrhagic shock （P 〈0.05）. Auxiliary T lymphocytes （CD3＋CD4＋） decreased gradually while suppressor T lymphocytes （CD3＋CD8＋） increased gradually. Terminal ileum villus edema, epithelial cell loss and inflammatory cell infiltration gradually increased. [ Conclusion ] This study demanstrates that the levels of serum endotoxin, D-lactate and diamine oxidase are positively correlated with the pathological changs of intestinal wall, while negatively ＂correlated with CD4 ＋/CD8 ＋ ratio after severe trauma-hemorrhagic shock. The changes above happens almost synchronously. Therefore, the study implies that the ischemia and hypoxia of intestinal epithelials during traumatie-hamorrhagic shock are correlated with the increase of intestinal permeability and the decrease of cell immune function.
出处
《中国现代医学杂志》
CAS
CSCD
北大核心
2011年第34期4248-4253,共6页
China Journal of Modern Medicine
关键词
创伤
休克
细胞免疫
淋巴细胞亚群
小肠绒毛
trauma
shock
cellular immunity
lymphocyte subsets
small intestine villi
