体外循环对小儿中性粒细胞凋亡及其调控蛋白的影响被引量：4

Effects of Extracorporeal Circulation on Polymorphonuclear Neutrophil Apoptosis and Related Protein in Pediatric

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摘要目的动态观察患儿在体外循环(extracorporeal circulation,ECC)各时段外周血中性粒细胞(polymorphonu-clear neutrophil,PMN)的凋亡率,及其脂肪酸合成酶(Fas)、B细胞淋巴瘤(Bcl-2)蛋白表达的变化规律,为临床从PMN凋亡调控入手防治ECC引发的全身炎性反应(SIRS)提供实验室依据。方法选择择期ECC下行室间隔缺损修补术的患儿30例,采用流式细胞术检测ECC前(T0),ECC开始后30 min(T1),停ECC后30min(T2),术后24 h(T3)各时点静脉血中PMN的凋亡率、Fas和Bcl-2的表达。结果与T0比较,PMN凋亡率在T2达最低值(P<0.05),与ECC持续时间呈负相关(r=-0.648,P<0.05);与T0比较,PMN膜上Fas阳性表达百分数在T2时点降低(P<0.05),与PMN凋亡率呈正相关(r=0.546,P<0.05);与T0比较,T1、T2、T3时点PMN胞内Bcl-2阳性表达百分数升高(P<0.05),与PMN凋亡率呈负相关(r=-0.569,P<0.05)。结论小儿ECC触发全身炎性反应的过程中产生的多种凋亡抑制因素使PMN凋亡受到抑制,其机制与PMN的Fas表达下调和Bcl-2表达上调有关。 OBJECTIVE To investigate the changes in polymorphonuclear neutrophil（PMN） apoptosis and Fas, Bcl - 2 protein expression of pediatric patients undergoing open - heart surgery with ECC, and to give the experimental basis for treating systemic inflammatory reaction syndrome（SIRS）. METHODS Thirty pediatric patients with ventricular septal defect undergoing open - heart surgery with ECC were studied. Blood samples were taken after induction of anesthesia （T0） ,30 minutes after the initiation ECC（ T1 ） ,30 minutes after the termination ECC（T2） and 24 hours post - operatively（T3）. PMN apoptosis and the expression of PMN Fas, Bcl- 2 protein were detected by flow cytometry. RESULTS Compared with TO, the rate of PMN apoptosis reached to its lowest value at T2（ P 〈 0.05 ）. The percentage of PMN apoptosis correlated negatively with the duration of ECC （ r = - 0.648, P 〈 0.05 ）. Fas on PMN membrane at T2 was significantly downregulated than TO. Fas levels correlated positively with PMN apoptosis rate （ r = 0.546, P 〈 0.05 ）. PMN intracellular expression of Bcl - 2 at T1,T2, T3 was significantly upregulated than TO （ P 〈 0.05 ）. Bcl - 2 levels correlated negatively with PMN apeptosis rate（ r = -0. 569, P 〈 0.05 ）. CONCLUSION The PMN apoptosis can be delayed by ECC. The inhibition of PMN apoptosis has relation with the down regulation expression of Fas and the upregulation expression of Bcl -2.

作者赵砚丽李建立武懿刘晓明杜彦茹闫志军

机构地区河北省人民医院麻醉科河北省人民医院心外科

出处《中国体外循环杂志》 2008年第1期5-7,4,共4页 Chinese Journal of Extracorporeal Circulation

基金河北省科技攻关与发展项目(07276201D-6)

关键词体外循环中性粒细胞细胞凋亡脂肪酸合成酶 B细胞淋巴瘤 Extracorporeal circulation Polymorphonuclear neutrophil Apoptosis Fatty acid synthetase B cell lymphoma-2

分类号 R726.5 [医药卫生—儿科]

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