中国危重病急救医学
中國危重病急救醫學
중국위중병급구의학
CHINESE CRITICAL CARE MEDICINE
2010年
6期
346-350
,共5页
付文政%毛岸荣%罗天航%方国恩
付文政%毛岸榮%囉天航%方國恩
부문정%모안영%라천항%방국은
内皮祖细胞%多器官功能障碍综合征%骨髓%血液%流式细胞仪
內皮祖細胞%多器官功能障礙綜閤徵%骨髓%血液%流式細胞儀
내피조세포%다기관공능장애종합정%골수%혈액%류식세포의
Endothelial progenitor cell%Multiple organ dysfunction syndrome%Bone marrow%Blood%Flow cytometry
目的 探讨骨髓内皮祖细胞(EPCs)在创伤后多器官功能障碍中的变化特点及意义.方法 18头小型家猪按随机数字表法分为实验组(9头)和对照组(9头).实验组动物采用失血性休克-内毒素二次打击方法制备多器官功能障碍综合征(MODS)模型.设伤后正常状态(T1)以及注射脂多糖(LPS)前(T2)和注射后即刻(T3)、24 h(T4)、48 h(T5)5个时间点抽取骨髓和外周血,加入红细胞裂解液,显微镜下计算有核细胞数;用流式细胞仪测定骨髓和外周血中EPCs含量,并计算EPCs绝对数值,对结果进行统计学分析.结果 对照组T1、T2、T3、T4、T 5时骨髓中EPCs(×106/L)分别为7.64±0.68、7.32±0.55、7.58±1.13、7.77±0.70、7.88±0.84,外周血中EPCs(×106/L)分别为3.54±0.26、4.06±0.64、3.74±0.55、3.61±0.37、3.98±0.63;实验组骨髓中EPCs(×106/L)分别为7.45±1.55、6.58±0.80、11.27±1.20、10.88±1.15、8.36±2.88,外周血中EPCs(×106/L)分别为3.21±0.48、8.71±2.04、5.98±0.77、1.27±0.91、2.14±0.96.实验组T3、T4、T5时骨髓中EPCs明显高于对照组;T2、T3、T4、T5时外周血中EPCs与对照组有明显差异,且各时间点骨髓中EPCs明显高于外周血中(均P＜0.05).结论 失血性休克后MODS发生发展过程中外周血EPCs先出现明显升高,然后迅速下降;而骨髓EPCs先略有下降,后明显升高,出现MODS后下降.EPCs的变化在MODS的转归中起重要作用.
目的 探討骨髓內皮祖細胞(EPCs)在創傷後多器官功能障礙中的變化特點及意義.方法 18頭小型傢豬按隨機數字錶法分為實驗組(9頭)和對照組(9頭).實驗組動物採用失血性休剋-內毒素二次打擊方法製備多器官功能障礙綜閤徵(MODS)模型.設傷後正常狀態(T1)以及註射脂多糖(LPS)前(T2)和註射後即刻(T3)、24 h(T4)、48 h(T5)5箇時間點抽取骨髓和外週血,加入紅細胞裂解液,顯微鏡下計算有覈細胞數;用流式細胞儀測定骨髓和外週血中EPCs含量,併計算EPCs絕對數值,對結果進行統計學分析.結果 對照組T1、T2、T3、T4、T 5時骨髓中EPCs(×106/L)分彆為7.64±0.68、7.32±0.55、7.58±1.13、7.77±0.70、7.88±0.84,外週血中EPCs(×106/L)分彆為3.54±0.26、4.06±0.64、3.74±0.55、3.61±0.37、3.98±0.63;實驗組骨髓中EPCs(×106/L)分彆為7.45±1.55、6.58±0.80、11.27±1.20、10.88±1.15、8.36±2.88,外週血中EPCs(×106/L)分彆為3.21±0.48、8.71±2.04、5.98±0.77、1.27±0.91、2.14±0.96.實驗組T3、T4、T5時骨髓中EPCs明顯高于對照組;T2、T3、T4、T5時外週血中EPCs與對照組有明顯差異,且各時間點骨髓中EPCs明顯高于外週血中(均P＜0.05).結論 失血性休剋後MODS髮生髮展過程中外週血EPCs先齣現明顯升高,然後迅速下降;而骨髓EPCs先略有下降,後明顯升高,齣現MODS後下降.EPCs的變化在MODS的轉歸中起重要作用.
목적 탐토골수내피조세포(EPCs)재창상후다기관공능장애중적변화특점급의의.방법 18두소형가저안수궤수자표법분위실험조(9두)화대조조(9두).실험조동물채용실혈성휴극-내독소이차타격방법제비다기관공능장애종합정(MODS)모형.설상후정상상태(T1)이급주사지다당(LPS)전(T2)화주사후즉각(T3)、24 h(T4)、48 h(T5)5개시간점추취골수화외주혈,가입홍세포렬해액,현미경하계산유핵세포수;용류식세포의측정골수화외주혈중EPCs함량,병계산EPCs절대수치,대결과진행통계학분석.결과 대조조T1、T2、T3、T4、T 5시골수중EPCs(×106/L)분별위7.64±0.68、7.32±0.55、7.58±1.13、7.77±0.70、7.88±0.84,외주혈중EPCs(×106/L)분별위3.54±0.26、4.06±0.64、3.74±0.55、3.61±0.37、3.98±0.63;실험조골수중EPCs(×106/L)분별위7.45±1.55、6.58±0.80、11.27±1.20、10.88±1.15、8.36±2.88,외주혈중EPCs(×106/L)분별위3.21±0.48、8.71±2.04、5.98±0.77、1.27±0.91、2.14±0.96.실험조T3、T4、T5시골수중EPCs명현고우대조조;T2、T3、T4、T5시외주혈중EPCs여대조조유명현차이,차각시간점골수중EPCs명현고우외주혈중(균P＜0.05).결론 실혈성휴극후MODS발생발전과정중외주혈EPCs선출현명현승고,연후신속하강;이골수EPCs선략유하강,후명현승고,출현MODS후하강.EPCs적변화재MODS적전귀중기중요작용.
Objective To investigate characteristics of changes in bone marrow endothelial progenitor cells (EPCs) and implications on multiple organ dysfunction syndrome (MODS) as a result of trauma.Methods Eighteen mini-pigs were randomized into two groups: MODS group (n=9) and control group (n=9).The animal models of MODS were reproduced by "two-hit" injury with hemorrhagic shock and lipopolysaccharide (LPS) injection.Bone marrow and peripheral blood of them were collected at five time points: normal condition (T1), before injection of LPS (T2), and 0 (T3), 24 (T4) and 48 hours (T5) after injection of LPS.Erythrocytic lysate was added to the samples, and the number of leucocytes in every sample was counted.The rate of EPCs in each sample was determined by flow cytometry.Number of EPCs in bone marrow and peripheral blood were calculated, and the results were analyzed statistically.Results The number of EPCs (×106/L) in bone marrow of control group at T1-5 was 7.64±0.68,7.32±0.55, 7.58±1.13, 7.77±0.70, and 7.88±0.84, respectively, and in peripheral blood control group was 3.54±0.26,4.06±0.64, 3.74±0.55, 3.61±0.37, and 3.98±0.63, respectively.The number of EPCs (×106/L) in bone marrow in the experimental group was 7.45 ± 1.55, 6.58 ± 0.80, 11.27 ± 1.20, 10.88±1.15, and 8.36 ± 2.88, respectively.The number of EPCa (× 106/L) in peripheral blood in the experimental group was 3.21±0.48, 8.71±2.04, 5.98±0.77, 1.27±0.91, and 2.14±0.96, respectively.The number of EPCs in bone marrow of experimental group was larger than that of control group at T3, T4, T5.The number of EPCs in the experimental group in peripheral blood was larger than that of control group at T2, T3, T4, T5.The number of EPCs in bone marrow was larger than that in peripheral blood at every time point (all P＜0.05).Conclusion The number of EPCs in peripheral blood elevates sharply in the earlier period, then plummetes quickly during MODS after a trauma.While the number of EPCs in bone marrow descends mildly at first, then rises obviously.Along with the aggravation of MODS, a declination of EPCs in bone marrow emerges.The change in bone marrow EPCs plays an important role in recovery of MODS.
