论文部分内容阅读
目的探讨类胰蛋白酶、TNF-α在羊水栓塞中的变化及病理生理作用。方法精选雌性鼠30只于妊娠20天制作羊水栓塞模型。根据注入液体性质不同随机分为对照组(10只)、羊水组(10只)、胎粪液组(10只)。对照组除注入生理盐水外,皆同其余组。实验后取鼠左肺行H.E染色光镜下观察,采用专性底物对模型鼠的血清类胰蛋白酶酶活力进行测定。免疫法检测血中肿瘤坏死因子(TNF-α)含量。结果 1.实验组肺组织可见大量炎性细胞浸润,包括白细胞(主要为中性粒细胞)、巨噬细胞及少量淋巴细胞。2.生理盐水组注入前后类胰蛋白酶水平无明显差异(P>0.05);鼠原羊水组和胎粪液组注入后类胰蛋白酶水平明显升高,差异显著(P<0.01)。3、实验组中TNF-α含量较对照组高,差异显著(P<0.01)。结论肥大细胞脱颗粒释放类胰蛋白酶可能是羊水栓塞的重要原因,在此基础上引起中性粒细胞、巨噬细胞浸润及一系列病理变化,由此引起肺损伤及临床症状。该酶学方法灵敏、有效,在羊水栓塞临床早期诊断中有一定的应用价值。
Objective To investigate the changes of tryptase and TNF-α in amniotic fluid embolism and their pathophysiological effects. Methods 30 female rats were selected for amniotic fluid embolism model at 20 days gestation. According to the different injection of liquid properties were randomly divided into control group (10), amniotic fluid group (10), meconium solution group (10). Control group in addition to saline, all with the rest of the group. After the experiment, the left lung of the rats was examined by H.E staining and the tryptase activity of the model mice was determined by using specific substrates. Immunoassay was used to detect the level of tumor necrosis factor (TNF-α) in the blood. Results 1. The experimental group of lung tissue showed a large number of inflammatory cell infiltration, including white blood cells (mainly neutrophils), macrophages and a small amount of lymphocytes. There was no significant difference in tryptase levels before and after injection (P> 0.05). The levels of tryptase in the amniotic fluid and meconium groups were significantly increased after injection (P <0.01). The content of TNF-α in the experimental group was higher than that in the control group (P <0.01). Conclusion Mast cells degranulation release of tryptase may be an important cause of amniotic fluid embolism. On the basis of this, neutrophils and macrophages infiltration and a series of pathological changes are caused, which cause lung injury and clinical symptoms. The enzymatic method is sensitive and effective, and has certain value in the early clinical diagnosis of amniotic fluid embolism.