爆炸冲击波对肺微血管内皮细胞损伤作用的病理学观察

目的 :通过观察爆炸冲击波对肺微血管内皮细胞的损伤 ,了解伤后微循环功能变化的病理学基础。方法 :采用爆炸冲击波对兔损伤动物模型以及对培养肺微血管内皮细胞损伤体外模型 ,从光镜、电镜水平上观察内皮细胞病理学变化。结果 :光镜下的主要表现为肺泡出血、肺泡隔断裂、肺大泡形成以及肺间质水肿 ,电镜下可见肺微血管内皮细胞肿胀致使血管腔狭窄 ,内皮细胞间裂隙增宽 ,核肿胀、异染色质增多 ,以及线粒体肿胀、嵴排列混乱等病理变化。体外实验主要表现为爆炸冲击波对培养的肺微血管内皮细胞的剥脱性损伤。结论 :爆炸性冲击伤后肺微内皮细胞的损伤严重且广泛 ,是伤后肺微血管通透性变化与肺微循环功能障碍发生的重要病理基础。

Pathologic Observation of Pulmonary Microvascular Endothelial Cells Exposed to Explosive Blast

Objective: To understand the pathologic basis of pulmonary microcirculation function changes after explosive wound,the pathological changes of the pulmonary microvascular endothlial cells injuries caused by explosive blast have been observed.Method: The animal model of the explosive wound in rabbits and the cultured pulmonary microvascular endothelial cells experiment model in vitro have been used.The pathologic changes have been observed in light microscopic level and electron microscopic level.Results: After exposed to explosive blast,there are the tearing of the inter alveolar septa with capillary repture,intra alveolar haemorrhage,forming of giant bullous lung,the pulmonary interstitial edema under light microscope;and the swellon pulmonary vascular endothelial cells obstructed the lumen of the capillary,the interstice between endothelial cells increased,the nucleus swolled,the heterochromation increased,the mitochondria swolled and the crista arrangement disordered have been observed under electron microscope.In the experiment of the microvascular endothelial cells exposed to explosive blast in vitro,the injure form is the stripping of endothlial cells.Conclusion: After exposed to explosive blast,the pulmonary vascular endothelial cells will suffer serious and far ranging injuries,which is the important pathological basis of the pulmonary microcirculation dysfunction and pulmonary microvascular permeability changes.