急性呼吸窘迫综合征患者肺组织细胞凋亡及Fas/FasL表达的变化及意义

The role of apoptosis and Fas/FasL in lung tissue in patients with acute respiratory distress syndrome

目的 探讨细胞凋亡在急性呼吸窘迫综合征（ＡＲＤＳ） 发病中的作用机制。方法 ＡＲＤＳ组９ 例，对照组５ 例，采用ＴＵＮＥＬ法以及免疫组织化学技术观察ＡＲＤＳ患者肺组织细胞凋亡及Ｆａｓ／ＦａｓＬ系统表达的变化。结果 ＡＲＤＳ急性期患者肺组织细胞凋亡率明显高于对照组，且主要表现为肺泡上皮和肺血管内皮细胞凋亡增加；Ｆａｓ 抗原、ＦａｓＬ在ＡＲＤＳ急性期患者肺组织中的表达与对照组比较明显上调，并且与肺组织细胞凋亡增加呈正相关。结论 肺泡上皮和肺血管内皮细胞凋亡增加和Ｆａｓ／ＦａｓＬ系统活化可能参与ＡＲＤＳ急性期的发病。

Objective To evaluate the effects of apoptosis and expression of apoptotic related genes on acute respiratory distress syndrome (ARDS) Methods Nine patients with ARDS and 5 non ARDS patients were included By using TUNEL、histopathology and immunocytochemistry techniques, apoptosis and Fas、FasL protein expression were studied in patients with ARDS in acute stage and in control subjects Results Apoptosis ratio was significantly higher in lung tissues in the patients with ARDS than in those of control subjects, especially in alveolar epithelial cells and pulmonary vascular endothelial cells Fas、FasL protein expression were up regulated in lung tissues of patients with ARDS There was a significant correlation between expression of Fas、FasL and ratio of apoptosis Conclusions During the acute stage of ARDS, increase of apoptosis ratio in alveolar epithelial cells and pulmonary vascular endothelial cells, and activation of Fas/FasL system may contribute to the pathogenesis of this syndrome