股骨干骨折合并脑损伤对大鼠肺泡Ⅱ型上皮细胞超微结构的影响

Influence of Femoral Shaft Fracture Combined with Traumatic Brain Injury on Type Ⅱ Alveolar Epithelial Cell Ultrastructure in Rats

目的研究股骨干骨折、脑损伤、股骨干骨折合并脑损伤3种不同创伤对大鼠肺泡Ⅱ型上皮细胞(alve-olar epithelial cell typeⅡ,ACE-Ⅱ)超微结构的影响。方法将108只SD大鼠随机分为对照组(大鼠不做任何处理,12只)、股骨干闭合骨折组(32只)、脑损伤组(32只)、股骨干闭合骨折合并脑损伤组(32只)4组,制备相关模型。分别在造模后1、6、12、24 h取大鼠右肺下叶组织,用透射电镜观察ACE-Ⅱ超微结构的病理变化并进行分析。结果电镜下超微结构的改变:ACE-Ⅱ超微结构的变化以嗜饿性板层小体(lamellar body,LB)为主;ACE-Ⅱ评分比较:在造模后1、6、12、24 h,3个研究组ACE-Ⅱ评分与对照组比较均升高(P<0.05);股骨干闭合骨折合并脑损伤组ACE-Ⅱ评分分别与股骨干闭合骨折组及脑损伤组比较,差异均有统计学意义(P<0.05)。股骨干闭合骨折组与脑损伤组ACE-Ⅱ评分均在造模后6 h达高峰(P<0.05),之后逐渐下降,脑损伤组ACE-Ⅱ评分在造模后24 h又升高(P<0.05);股骨干闭合骨折合并脑损伤组ACE-Ⅱ评分造模后24 h内持续升高(P<0.05)。结论大鼠ACE-Ⅱ对创伤表现出较强的敏感性。损伤较轻时,ACE-Ⅱ表现为代偿能力增强,严重创伤会致其凋亡。

Objective To study effects of femoral shaft fracture, traumatic brain injury, and femoral shaft frac- ture combined with traumatic brain injury on type Ⅱ alveolar epithelial cell ultrastructure in rats. Methods Sprague- Dawley rats were randomly divided into control group （rats without treating with anything, n = 12） , closed femoral frac- ture group （ n = 32） , traumatic brain injury group （ n = 32） , and closed femoral shaft fracture combined with traumatic brain injury group （ n = 32） , and corresponding models were performed. Ultrastructural pathological changes of right lung tissue in rats ACE- Ⅱ in the four groups were observed with transmission electron microscope at 1,6, 12 and 24 hour after modeling. Results Ultrastructural pathological changes with electron microscope： the major ultrastructural pathological change of lung tissue ACE- Ⅱ was lamellar body （LB） ; The comparison of ACE- Ⅱ scores： the ACE- Ⅱ scores of three experiment groups were higher than those of control group at 1, 6, 12 and 24 hour after modeling （P 〈0.05） ; the ACE- Ⅱ score in closed femoral shaft fracture combined with traumatic brain injury group was compared with those in closed femoral fracture group and traumatic brain injury group, and the differences were statistically significant （ P 〈 0.05 ）. At 6 hour after modeling, the ACE-Ⅱ scores had reached maximum in both the closed femoral shaft fracture group and the traumatic brain injury group （P 〈 0.05） , then decreased gradually in the two groups, but the ACE- Ⅱ score of the trau- matic brain injury group had elevated again at 24 hour after modeling （P 〈 0.05） ; During the 24 hours after modeling, the ACE- Ⅱ score of the closed femoral shaft fracture combined with traumatic brain injury group had been elevated con- tinuously （P 〈 0.05）. Conclusion Rats＇ ACE- Ⅱ is more sensitive to trauma. Minor injury of ACE- Ⅱ may make the compensatory ability to get enhancement, while trauma can cause apoptosis.