多器官衰竭时肠黏膜肥大细胞活性的变化研究

Increasing activity of the intestinal mucosal mast cells in rats with multiple organ failure

目的 :研究多器官衰竭 (MOF)时肠黏膜肥大细胞 (IMMC)活性的变化 ,从黏膜免疫的角度探讨 MOF的病理生理机制。方法 :酵母多糖注射法制作 MOF大鼠模型 ,测定 MOF急性期及恢复期外周血和小肠局部组胺、肿瘤坏死因子α(TNFα)浓度 ;观察各重要脏器组织学及功能改变 ;记录 IMMC数量和超微结构变化。结果 :MOF时大鼠小肠、肝、肾、肺等在病理形态上出现广泛急性炎症改变 ,功能明显受损。小肠局部组胺浓度为 (8.6 7± 1.16 ) ng/ g,比正常组 (11.6 3± 1.97) ng/ g明显降低 (P<0 .0 1) ;而外周血组胺浓度无明显变化(P>0 .0 5 )。小肠局部 TNFα浓度为 (15 .6 8± 1.81) pg/ g,较正常组 (3.18± 0 .72 ) pg/ g明显升高 (P<0 .0 1) ;外周血 TNFα浓度为 (12 .83± 1.10 ) ng/ L,亦较正常组 (0 ng/ L)明显升高 (P<0 .0 1)。IMMC数量较正常组增加约 2倍 ,呈明显的脱颗粒改变 ;IMMC的超微结构变化与 MOF病理变化一致。MOF恢复期上述指标与正常组比较无显著性差异。结论 :MOF时 IMMC活性明显增加 ,IMMC通过释放组胺、分泌 TNFα参与 MOF的病理生理过程。

Objective:To investigate changes in activities of the intestinal mucosal mast cells (IMMC) in multiple organ failure(MOF).Methods:MOF model in rat was established by injection of zymosan. The concentrations of histamine and tumor necrosis factorα (TNFα) in plasma and intestine tissue were examined. Both the function and the pathological alterations of vital organs including intestine,liver,kidneys and lungs were measured or visualized under light microscope.Furthermore,the ultrastructure of the IMMC was observed with a transmission electronic microscope.Results:The injection of zymosan resulted in obvious inflammatory response in multiple organs,as well as significantly impaired function.Compared with the normal rats,the histamine levels in the intestinal tissue from rats with MOF remarkably decreased 〔(11 63± 1 97) ng/g vs.(8 67±1 16) ng/g〕,while the plasma histamine levels did not show any significant changes.For TNFα,apparently increasing levels in both intestinal tissue and plasma were observed in MOF rats.Meanwhile,the increasing number and degranulation of IMMC during MOF were impressive.Conclusion:The histamine and TNFα released from activated IMMC may play an important role in the development of MOF.