腹部肠管火器伤后肝组织COX-2的表达与内毒素血症的关系

Relationship between expressions of hepatic COX-2 and intestinal endotoxemia after intestinal firearm wound

目的探讨环氧化酶-2(COX-2)在腹部肠管火器伤后肝组织中表达的变化及其与肠源性内毒素血症的关系。方法健康长白仔猪42头随机等分为对照组和伤后1、2、4、8、12、24小时组,实验组建立腹部火器伤肠管穿透模型后,用显色基质鲎试剂法检测各组血浆内毒素水平;免疫组化图像分析法测定各组肝组织COX-2的表达,同时测定血清中谷丙转氨酶(ALT)水平。结果伤后各组血浆内毒素水平、肝组织COX-2的表达及血清ALT水平均明显高于对照组(P<0.05)。血浆内毒素水平于伤后8小时出现高峰,伤后12小时仍维持在高峰值水平;肝组织COX-2的表达及血清ALT水平均于伤后2小时和12小时出现2个高峰。相关分析表明,伤后肝组织COX-2与血浆内毒素及血清ALT水平均呈正相关(r值分别为0.718、0.850,P<0.05)。结论腹部肠管火器伤后COX-2的表达与内毒素血症密切相关,COX-2在腹部肠管火器伤继发性肝损伤中可能起重要作用。

Objective To investigate the changes of expressions of hepatic COX-2 and the relationship between hepatic COX-2 and intestinal endotoxemia after intestinal firearm wound. Methods A total of 42 Chang-Bai piglets were randomized into 7 groups： control group and wounded 1,2,4,8,12,24 hour groups. The models of intestinal firearm wound were established in wounded groups. Levels of plasma endotoxin was measured by using chromogenic limulus amebocyte lysate test;Hepatic COX-2 expression were measured with immunohistochemical staining and image analysis in all groups. Levels of serum ALT were determined. Results Levels of plasma endotoxin, hepatic COX-2 expressions, serum ALT in wounded groups were all significantly elevated compared to control group（ P 〈 0.05）. Plasma endotoxin reached the peak in 8h group, and it was still at the peak level in 12h group; Expressions of both hepatic COX-2 and serum ALT appeared two peaks in 2h group and 12h group. In addition, the level of hepatic COX-2 was positively correlated with plasma endotoxin and serum ALT （ r = 0.718 and 0. 850, P 〈 0.05 ）. Conclusion After intestinal firearm wound, the expressions of hepatic COX-2 intimately correlated with endotoxemia, COX-2 may play an important role in subsequent liver injury after the firearm wound.