腹部火器伤肠管穿透后NF-κB在肝损伤发病机制中的作用

Role of NF-κB in the mechanism of liver injury following intestinal perforations due to abdominal firearm wound in pigs

目的:探讨NF-κB在腹部火器伤肠管穿透后肝损伤发病机制中的作用。方法:健康长白仔猪42头随机等分为对照组和伤后1、2、4、8、12和24h组,伤后各组建立腹部火器伤肠管穿透模型后,用免疫组织化学图像分析法测定各组肝内NF-κB、TNF-α含量,同时测定肝细胞凋亡和血清中ALT水平变化情况,在光学显微镜下观察各组肝脏组织学变化。结果:伤后各组肝内NF-κB活性明显高于对照组,并于伤后1h和8h出现2个高峰(P<0.05);伤后各组肝内TNF-α含量、肝细胞凋亡指数和血清ALT水平均明显高于对照组,并于伤后2h和12h出现2个高峰(P<0.05);伤后各组出现逐渐加重的肝细胞水肿、变性、坏死。相关分析表明NF-κB与TNF-α、肝细胞凋亡指数均有正相关关系(P<0.05)。结论:腹部火器伤肠管穿透后NF-κB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。

Objective：To study the role of NF- κB in the mechanism of liver injury following intestinal perforations due to abdominal firearm wound. Methods：A total of 42 Chang-Bai piglets were assigned randomly into 7 groups： control group and wounded 1, 2, 4, 8, 12, 24 hours group.The model of intestinal perforations due to abdominal firearm wound was established in wounded groups. Hepatic NF-κB and TNF-α content was measured with immunohistochemical staining and image analysis in all groups. Hepatocyte apoptosis indexes and serum ALT levels were also determined at the same time. The alterations of hepatic tissue were observed under light microscope. Results： Levels of hepatic NF-κB activity in wounded groups were significantly elevated compared with control group, and two peaks appeared in 1 h group and 8 h group, respectively （P〈0.05）. Mean- while, hepatic TNF-α content, levels of serum ALT and hepatocyte apoptosis indexes were markedly increased compared with control group, and two peaks appeared in 2 h group and 12 h group, respectively （P〈0.05）. Observing under light microscope, hepatocyte edema, necrosis and metamorphosis were gradually aggravated from 1 h group to 24 h group. Conclusion：After in- testinal perforations due to abdominal firearm wound, hepatic NF- κ B mediates hepatocyte apoptosis and enhances the expression of TNF-α simultaneously, which can collectively induce subsequent liver injury after the wound.