创伤致休克和多器官功能不全综合征中的细胞凋亡研究

A study of the apoptosis in cases of the shock and multiple organ dysfunction syndrome induced by trauma

研究创伤致休克和多器官功能不全综合征中的细胞凋亡 ,探讨细胞凋亡在创伤性休克和多器官功能不全综合征中的发生机理及其在法医学上的应用。用TUNEL末端标记、流式细胞仪等方法 ,对广泛软组织挫伤死亡尸解15例的肝、肾、心、脑等组织进行凋亡检测。其中因创伤性休克死亡 10例 ;因MODS死亡 5例。TUNEL末端标记法检测 :创伤休克组肝、肾、心、脑的细胞凋亡指数 (AI)明显高于对照组 ;创伤MODS组肝、肾、心、脑的细胞凋亡指数 (AI)明显高于创伤休克组和对照组 ,经统计学处理有显著性差异 (P <0 0 1)。流式细胞仪检测 :创伤休克组肝、肾、心、脑的凋亡峰值分别为 2 0 3 %、 19 1%、 18 6 %、 30 0 % ;创伤MODS组肝、肾、心、脑的凋亡峰值分别为 42 2 %、 45 1%、 39 7%、 6 2 9%。创伤致休克和MODS死亡人体尸解器官中细胞凋亡增多。

The aim of the present study is to inverstigate the apoptosis in cases of the shock and multiple organ dysfunction syndrome (MODS) induced by trauma, its mechanism and application in the forensic medicine practice Specimens of the liver, kidney, heart and brain were taken from each of 15 cases with extensive soft tissue contusion, ten out of 15 cases died of post traumatic shock and five cases died of MODS Apoptosis was detected by TUNEL assay and the flow cytometry(FCM) It was demonstrated by TUNEL method that the apoptosis indices (AIs) of the liver, kidney, heart and brain in the shock group were significantly higher than those in the control group( P <0 01) The AIs of these four organs in the MODS group werethose in the shock group ( P <0 01) The FCM histograms showed that the percentages of hypo diploid nuclei were 20 3% in liver, 19 1% in kidney, 18 6% in myocardium and 30 0% in brain in the shock group, while they rose to 42 2% in liver, 45 1% in kidney, 39 7% in myocardium and 62 9% in brain in the MODS group It is demonstrated that the percentages of apoptosis increased significantly in these four organs of the shock and MODS victims induced by the trauma