急性出血坏死性胰腺炎时细胞粘附分子表达对中性粒细胞在肺脏聚集的影响

Influences of cell adhesion molecules expression on pulmonary neutrophil aggregation in hemorrhagic necrotic pancreatitis

目的：探讨急性出血坏死性胰腺炎（ＡＨＮＰ）时中性粒细胞（ＰＭＮ）聚集于肺脏的机制。方法：利用ＡＨＮＰ并发急性肺损伤（ＡＬＩ）大鼠模型，采用免疫组化技术等方法，动态观察ＡＨＮＰ后大鼠肺脏实质细胞间粘附分子１（ＩＣＡＭ１）、ＰＭＮ表面巨噬细胞分化抗原１（ＣＤ１１ｂ／ＣＤ１８）的表达改变和ＰＭＮ肺脏聚集的变化。结果：ＡＨＮＰ后，肺脏ＩＣＡＭ１表达逐渐增加，与ＰＭＮ肺脏聚集程度呈显著正相关，而ＰＭＮ表面ＣＤ１１ｂ／ＣＤ１８在ＡＨＮＰ后１小时即迅速表达至高峰，并持续２４小时保持此高表达状态。结论：ＡＨＮＰ后，ＰＭＮ在肺脏的大量聚集是建立在ＰＭＮ表面ＣＤ１１ｂ／ＣＤ１８与肺实质细胞ＩＣＡＭ１高表达的基础之上，而ＩＣＡＭ１为这一粘附过程中的可变因素。

Objective:To explore the potential mechanism of pulmonary polymorphonuclear neutrophil (PMN) aggregation after acute hemorrhagic necrotic pancreatitis (AHNP).Methods:Using rat model of AHNP complicating acute lung injury (ALI),we dynamically observed the changes in intercellular adhesion molecule1( ICAM1 ) expression in lung tissue,CD 11b /CD 18 expression on PMN,and pulmonary PMN aggregation.Results:The pulmonary ICAM1 expression gradually increased,which significantly correlated with the PMN accumulation after AHNP.CD 11b /CD 18 expression on PMN reached the peak value at 1 hour and maintained high expression till 24 hours.Conclusions:Pulmonary PMN aggregation is based on increased expression of ICAM1 in lung tissue and CD 11b /CD 18 on PMN after AHNP.Furthermore,ICAM1 may be a principal factor in mediating pulmonary PMN aggregation and adhesion between PMN and lung vascular endothelial cell(VEC) after AHNP.