创伤后肺炎性细胞凋亡与继发性坏死的意义

ANALYSIS FO APOPTOSIS AND SECONDARY NECROSIS IN INFLAMMATORY CELLS AFTER TRAUMA

目的:探讨严重创伤后炎性细胞凋亡与继发性坏死在急性损伤发病机制中的地位和作用。方法:复制大鼠多在骨折合并休克模型,采用Annexin—V和propidium iodide双标法经流式细胞仪检测创伤后肺泡灌洗液中凋亡与坏死炎性细胞的数量变化,测定细胞分类计数及肺通透指数并作出比较。结果:伤后动物肺泡灌洗液中巨噬细胞数量减少,而白细胞数量增加。伤后凋亡炎性细胞数量增加,于伤后3h达到高峰。部分凋亡炎性细胞继而发生继发性坏死。其数量进行性升高并与肺通透指数变化显著相关(r=0.90,p<0.01)。结论:严重创伤后肺泡灌洗液中炎性细胞发生凋亡后可能通过继发性坏死造成炎性内容物的泄漏而引发急性肺损伤。

Objective: To research the pathogenic mechanisms of acute lung injury, apoptosis and secondary necrosis of inflammatory cells in bronchoalveolar lavage fluid(BALF)were investigated in early stage of severe trauma in rat models. Methods: After reproduction of severe traurma models of rats with multiple fractures and shock, the quantitative changes of apoptotic and secondary necrotic cells in BALF were analysised by flow cytometry applying double-staining technuque of Annexin-V and propidium iodide in different time-spot, meanwhile classification in BALF cells were perfomed and pemeability index were measured accordingly. Result:Classifications of BALF cells showed that the quantities of macrophages decreased, while the quantities of white blood cells increased as the time going after injury. The quantities of apoptotic cells in BALF were detected, which reached peak value in 3 hours after injury. Secondary necrosis occured in some apoptic cells;the quantities of which were significantly correlative with the increase of pemeability index(r=0.90,p<0. 01). Conclnslon: After severe injury, inflammatory cells in BALF commited apoptosis, part of apoptotic cells proceeded into secondary necrosis and toxic contents in these necrotic inflammatory cells leaked; which probably initiating acute lung injury.