冯艳红 黄茂萍 吴玉祥 殷国庆 杜开和

    【摘要】 目的 探讨L-选择素和P-选择素在内毒素休克肺损伤中的作用。方法 11只猕猴随机分为两组，脂多糖(LPS)组(n=6)，制备LPS休克模型，分别在LPS攻击前(0 min)、攻击60 min和120 min时采血，检测L-选择素和P-选择素；空白对照组(n=5)，也相应时间点采血。于两组均于实验120 min时处死动物，取肺组织进行电镜及选择素免疫组化观察。结果 LPS攻击120 min时电镜下可见猕猴肺组织出现Ⅰ、Ⅱ型上皮损伤及血管内皮、基底膜损伤，少量红细胞渗出。两组在LPS攻击0、60和120 min时L-选择素浓度均有所下降，其中LPS攻击120 min时两组L-选择素均较LPS攻击前明显下降(P均<0.05)，两组间比较差异均无显著性(P均>0.05)。两组P-选择素在各时间点均无明显变化(P均>0.05)，组间比较差异也无显著性(P均>0.05)。LPS组动物肺泡内可见P-选择素表达，血管内皮可见L-选择素，而空白对照组肺组织未见选择素表达。结论 休克早期出现肺损伤，肺组织P-选择素及L-选择素的表达早于血浆中的变化；选择素在猕猴肺损伤中起重要作用。

    【关键词】 休克，内毒素； 肺损伤； P-选择素； L-选择素； 猕猴

    Changes in selectin in early stage of lung injury induced by endotoxic shock in

    Macaque FENG Yan-hong, HUANG Mao-ping, WU Yu-xiang, YIN Guo-qing, DU Kai-he.Department of Internal Medicine, Nanjing the Second Hospital, Medical College, Southeast University, Nanjing 210003, Jiangsu, China

    【Abstract】 Objective To investigate the change in selectin and its effect on lung injury induced by endotoxic 〔lipopolysaccharide (LPS)〕 shock in macaque. Methods Eleven macaques were randomly divided into two groups: control group (n=5) and LPS group (n=6). The animals of the control group received injection of 1 ml/kg normal saline, and the animals of the LPS group received a dose of 2.8 mg/kg LPS intravenously. The plasma contents of P-selectin and L-selectin were assayed before LPSchallenge, 60 and 120 minutes after LPS challenge. Ultrastructure of lung tissue and immunohistochemical assay of P-selectin and L-selectin in the lung were observed. Results Administration of LPS did not changed P-selectin level in plasma, but decreased the L-selectin level at 120 minutes after LPS challenge in both groups (all P<0.05). By immunohistochemical staining, P-selectin and L-selectin were identified on endothelial cells of alveolar wall of LPS animals, whereas no positive staining of P-selectin and L-selectin was showed in control animals. Damages to alveolar type Ⅰand Ⅱ cells, slight transudation of red blood corpuscles, and damage to the basement membrane were observed with electron microscopy in the endotoxin challenged macaques. No pathological changes were observed in the control group. Conclusion Administration of LPS induces expression of P-selectin and L-selectin in alveolar wall and causes alveolar damages in early-phase of endotoxic shock. In the meantime, the L-selectin and P-selectin in plasma do not change. The selectins play an important role in the pathogenesis of lung injury in the early-phase of endotoxic shock. ......