内皮祖细胞在创伤后多器官功能障碍中的变化及意义

目的 探讨骨髓内皮祖细胞(EPCs)在创伤后多器官功能障碍中的变化特点及意义.方法 18头小型家猪按随机数字表法分为实验组(9头)和对照组(9头).实验组动物采用失血性休克-内毒素二次打击方法制备多器官功能障碍综合征(MODS)模型.设伤后正常状态(T1)以及注射脂多糖(LPS)前(T2)和注射后即刻(T3)、24 h(T4)、48 h(T5)5个时间点抽取骨髓和外周血,加入红细胞裂解液,显微镜下计算有核细胞数;用流式细胞仪测定骨髓和外周血中EPCs含量,并计算EPCs绝对数值,对结果进行统计学分析.结果 对照组T1、T2、T3、T4、T 5时骨髓中EPCs(×106/L)分别为7.64±0.68、7.32±0.55、7.58±1.13、7.77±0.70、7.88±0.84,外周血中EPCs(×106/L)分别为3.54±0.26、4.06±0.64、3.74±0.55、3.61±0.37、3.98±0.63;实验组骨髓中EPCs(×106/L)分别为7.45±1.55、6.58±0.80、11.27±1.20、10.88±1.15、8.36±2.88,外周血中EPCs(×106/L)分别为3.21±0.48、8.71±2.04、5.98±0.77、1.27±0.91、2.14±0.96.实验组T3、T4、T5时骨髓中EPCs明显高于对照组;T2、T3、T4、T5时外周血中EPCs与对照组有明显差异,且各时间点骨髓中EPCs明显高于外周血中(均P＜0.05).结论 失血性休克后MODS发生发展过程中外周血EPCs先出现明显升高,然后迅速下降;而骨髓EPCs先略有下降,后明显升高,出现MODS后下降.EPCs的变化在MODS的转归中起重要作用.

Changes in endothelial progenitor cells and their implications in multiple organ dysfunction syndrome caused by trauma in pigs

Objective To investigate characteristics of changes in bone marrow endothelial progenitor cells (EPCs) and implications on multiple organ dysfunction syndrome (MODS) as a result of trauma.Methods Eighteen mini-pigs were randomized into two groups: MODS group (n=9) and control group (n=9).The animal models of MODS were reproduced by "two-hit" injury with hemorrhagic shock and lipopolysaccharide (LPS) injection.Bone marrow and peripheral blood of them were collected at five time points: normal condition (T1), before injection of LPS (T2), and 0 (T3), 24 (T4) and 48 hours (T5) after injection of LPS.Erythrocytic lysate was added to the samples, and the number of leucocytes in every sample was counted.The rate of EPCs in each sample was determined by flow cytometry.Number of EPCs in bone marrow and peripheral blood were calculated, and the results were analyzed statistically.Results The number of EPCs (×106/L) in bone marrow of control group at T1-5 was 7.64±0.68,7.32±0.55, 7.58±1.13, 7.77±0.70, and 7.88±0.84, respectively, and in peripheral blood control group was 3.54±0.26,4.06±0.64, 3.74±0.55, 3.61±0.37, and 3.98±0.63, respectively.The number of EPCs (×106/L) in bone marrow in the experimental group was 7.45 ± 1.55, 6.58 ± 0.80, 11.27 ± 1.20, 10.88±1.15, and 8.36 ± 2.88, respectively.The number of EPCa (× 106/L) in peripheral blood in the experimental group was 3.21±0.48, 8.71±2.04, 5.98±0.77, 1.27±0.91, and 2.14±0.96, respectively.The number of EPCs in bone marrow of experimental group was larger than that of control group at T3, T4, T5.The number of EPCs in the experimental group in peripheral blood was larger than that of control group at T2, T3, T4, T5.The number of EPCs in bone marrow was larger than that in peripheral blood at every time point (all P＜0.05).Conclusion The number of EPCs in peripheral blood elevates sharply in the earlier period, then plummetes quickly during MODS after a trauma.While the number of EPCs in bone marrow descends mildly at first, then rises obviously.Along with the aggravation of MODS, a declination of EPCs in bone marrow emerges.The change in bone marrow EPCs plays an important role in recovery of MODS.