多器官功能障碍综合征时肠淋巴细胞再循环的变化

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45 min、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1 h,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.MODS 2组大鼠(n=6)于再灌注第3 h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51Cr标记后,于第6 h回输入大鼠的体内,1 h后取上述各组织或器官以检测51Cr-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(0.28±0.15)×107/h]较对照组(2.69±0 .61)×107/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 51Cr-淋巴细胞量分别占总51Cr细胞量为(5.04±1.23)%和(3. 23±1.69)%,显著高于对照组(2.69±2.19)% 和(1.11±0.75)%,P均<0.05,并伴随肠淋巴内毒素含量及肿瘤坏死因子-α(TNF-α)浓度显著增加及重要器官或组织功能损害.结论肠淋巴细胞归巢增加是MODS发病机制的一个重要方面.

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

OBJECTIVE: To observe the changes of intestinal mucosal lymphocyte homing in rats with multiple organ dysfunction syndromes (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)Cr-lymphocytes distribution in organs by gamma-counter. 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)X10(7)/h and (2.69+/-0.61)X10(7)/h respectively, while 51 Cr-intestinal 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 factor-alpha (TNF-alpha) in intestinal lymph were also elevated. CONCLUSION: Increased homing of intestinal mucosal lymphocyte is involved in MODS of rats.