NF-кB、TNF-α在腹部火器伤肠管穿透后肝损伤机制中的作用

The role of NF-кB and TNF-αin the mechanism of liver injury following intestinal perforations due to abdominal firearm wound in pigs

目的:探讨核因子-кαB、肿瘤坏死因子-α在腹部火器伤肠管穿透后肝损伤中的作用。方法:健康长白仔猪42头随机等分为对照组和伤后1h、2h、4h、8h、12h和24h组,实验组建立腹部火器伤肠管穿透模型后,用免疫组化图像分析法测定各组肝内N-кB、TNF-α表达,同时测定肝细胞凋亡和血清中ALT变化情况,在光镜下观察各组肝脏组织学变化。结果:伤后各组肝内NF-кB表达、TNF-α表达、肝细胞凋亡指数和血清ALT水平明显高于对照组,NF-кB表达于伤后1h和8h出现2个高峰(P<0.05);TNF-α表达、肝细胞凋亡指教和血清ALT水平于伤后2h和12h出现2个高峰(P<0.05);且第2个高峰值均大于第1个高峰值(P<0.05)。伤后1h、2h、4h组出现逐渐加重的肝细胞水肿、变性,伤后8h、12h、24h组出现逐渐加重的肝细胞点状坏死、灶状坏死和炎细胞浸润,对照组光镜下未见明显的损伤性变化。结论:腹部火器伤肠管穿透后,NF-кB可能在促进肝细胞凋亡的同时使TNF-α表达增多来共同介导肝损伤。

ABSTRACT Objective： To investigate the role of NF-κB and TNF-α in the mechanism of liver injtury following intestinal perforations due to abdominal firearm wound. Methods： 42 Chang-Bai piglets were randomized into 7 groups： control group and lhour group, 2 hour group, 4 hour group, 8 hour group, 12 hour group and 24 hour group after being wounded. The model of intestinal perforations due to abdominal firearm wound was established in wounded groups. The expression of hepatic NF-κB and TNF-α were determined by immunohistochemical staining and image analysis. Hepatocellular apoptosis indexes and serum ALT level were determined at the same time. The histological change of hepatic tissue was observed with light microscope. Results： The expression of hepatic NF-κB, hepatic TNF-α, hepatocellular apoptosis index and serum ALT level in wounded groups significantly increased in comparison with the control group, and that of hepatic NF-κB reached peak after 1 h and 8 h of injtu-y respectively （P〈0.05）; that of hepatic TNF-α, hepatocellular apoptosis index and serum ALT level reached peak after 2 h and 12 h of injury respectively （P〈0.05）. All the second：peak were higher than the first one （P〈0.05）. Hepatocellular edema and metamorphosis gradually aggravated the time after 4 h of injury. Hepatocellular punctiform necrosis necrosis and focus-form necrosis were observed after 8 h of injtury, and were increasing with the time. The control group had no changes. Conclusion： After intestinal perforations due to abdominal firearm wound, NF-κB mediates hepatocellular apoptosis and the expression of TNF-α simultaneously, which collectively induced subsequent liver injury aider the wound.