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目的研究猕猴在内毒素休克前后血气变化,肺的超微结构、溶酶体的变化、肺泡内血小板衍生长因子(PDGF)免疫组化的表现,探讨其在肺损伤中的意义。方法猕猴11只,6只为内毒素组,制成内毒素休克模型,分别在内毒素攻击前、攻击60 min、攻击120 min时采血,检测血气;5只为对照组,也在相应时点采血。内毒素组120 min时杀死动物,取肺组织做超微结构、电镜酸性磷酸酶细胞组织化学、PDGF免疫组化检测。结果内毒素组及对照组在内毒素攻击前、攻击60 min、120 min时气体交换指数无变化。内毒素组动物肺泡内见呼吸上皮、基底膜、血管内皮细胞损伤,细胞内溶酶体数量增多、破坏,PDGF阳性蛋白在肺泡间隔上沉积;而对照组动物肺泡内及血管内皮未见PDGF阳性染色、呼吸上皮和血管内皮无损伤,溶酶体结构正常。结论休克早期就有了肺部的损害,PDGF可能参与了早期肺组织损伤过程;而此损伤未影响换气指数变化。
Objective To study the changes of blood gas, ultrastructure of lungs, changes of lysosomes and immunohistochemistry of platelet-derived growth factor (PDGF) in the alveolar macrophages before and after endotoxin shock and to explore its significance in lung injury. Methods 11 macaques and 6 endotoxin groups were used to establish endotoxic shock model. Before endotoxin challenge, the animals were challenged for 60 min and challenged for 120 min respectively. Blood samples were collected for blood gas detection. Five control groups were also treated at the corresponding time points Blood collection. The animals were sacrificed at 120 min in the endotoxin group, and the lung tissue was taken for ultrastructure, electron microscopy, acid phosphatase cell histochemistry and PDGF immunohistochemistry. Results In the endotoxin group and the control group, the gas exchange index did not change before the endotoxin attack and 60 min after 120 min. In the endotoxin group, the alveolar epithelial cells, the basement membrane and the vascular endothelial cells were damaged, the number of intracellular lysosomes was increased, and the PDGF positive protein was deposited on the alveolar septa. In the control group, no positive PDGF was found in the alveoli and the vascular endothelium Staining, respiratory epithelium and vascular endothelial damage, lysosomal structure is normal. Conclusions Lung damage was observed early in shock. PDGF may be involved in the process of early lung injury. However, this injury did not affect the change of ventilation index.