多器官功能障碍综合征时肠淋巴细胞再循环的变化

Changes of intestinal mucosal lymphocyte homing in rats with multiple organ dysfunction syndrome

目的 观察大鼠肠缺血再灌注致多器官功能障碍综合征 ( MODS)后肠淋巴细胞归巢的改变 ,从肠黏膜免疫角度探讨肠淋巴细胞归巢在 MODS中的作用。方法 采用随机分组方法 ,用夹闭肠系膜动脉根部 4 5 m in、再灌注 6 h制备大鼠 MODS模型。MODS 1组大鼠 ( n=10 )于再灌注第 5 h从肠系膜淋巴管插管引流肠淋巴液 1h,检测淋巴细胞数及 T、B细胞比例 ,同时取肠、肝、肺、肾组织进行病理组织学观察 ;对照 1组( n=6 )大鼠仅单纯施行肠淋巴液引流。MODS2组大鼠 ( n=6 )于再灌注第 3h从肠系膜淋巴管插管引流肠淋巴液 2 h,肠淋巴细胞在体外经 51 Cr标记后 ,于第 6 h回输入大鼠的体内 ,1h后取上述各组织或器官以检测 51 Cr淋巴细胞在体内的分布 ;对照 2组单纯施行肠淋巴液引流及淋巴细胞标记后回输。结果 肠缺血再灌注致 MODS时 ,MODS组大鼠由肠黏膜迁移至血循环肠淋巴细胞总数〔( 0 .2 8± 0 .15 )× 10 7/ h〕较对照组〔( 2 .6 9± 0 .6 1)× 10 7/ h〕显著降低 ;而归巢至肠黏膜的肠淋巴细胞增加 ,派伊尔 ( Peyer)淋巴结及小肠内所分布的 51 Cr 淋巴细胞量分别占总 51 Cr细胞量为 ( 5 .0 4± 1.2 3) %和 ( 3.2 3± 1.6 9) % ,显著高于对照组 ( 2 .6 9±2 .19) %和 ( 1.11± 0 .75 ) % ,P均 <0 .0 5 ,并伴随肠淋巴内?

Objective To observe the changes of intestinal mucosal lymphocyte homing in rats with multiple organ dysfunction syndrome(MODS) and study the role of intestinal mucosal lymphocyte play in MODS . Methods A rat model of MODS was reproduced by occluding the superior mesenteric artery for 45 minutes followed by reperfusion for 6 hours. From the fifth hour after reperfusion, intestinal lymph of rats (MODS group 1, n =10) was collected for 1 hour. Intestinal lymph was also collected from rats of control group 1( n =6). The population of lymphocytes and the percentage of T and B cells were measured in both groups. From the third hour after reperfusion, intestinal lymph of rats (MODS group 2, n =6) was collected for 2 hours. Then, intestinal lymphocytes were labeled with 51 Cr and were infused into blood circulation again at the sixth hour of reperfusion. Various organs were taken out 1 hour later for measurement of 51 Crlymphocytes distribution in organs by γcounter. Intestinal lymph of control rats (group 2, n =6) was collected. Labeled lymphocytes were also infused into blood circulation of rats again. Results The number of lymphocytes from intestinal mucosa migrated into blood circulation was decreased, the counts were (0 28±0 15)×10 7/h and (2 69±0 61)×10 7/h respectively, while 51 Crintestinal lymphocytes homed to intestinal mucosa were increased in MODS induced by intestine ischemia/reperfusion.At the same time, the levels of endotoxin and tumor necrosis factorα(TNFα) in intestinal lymph were also elevated. Conclusion Increased homing of intestinal mucosal lymphocyte is involved in MODS of rats.