MODS大鼠胸腺树突状细胞病理改变及作用的研究

目的：探讨胸腺树突状细胞在多脏器功能障碍综合征（MODS）发病机制中的作用,为严重创伤后脓毒症和MODS的基础研究与临床防治提供新的思路。方法：运用光镜、电镜观察与免疫组织化学（CD1a与S－100）及原位末端标记法（TUNEL）研究MODS大鼠胸腺中树突状细胞的变化及其与细胞凋亡的关系。结果：复制小鼠酵母多糖MODS模型,伤后12小时（MODS早期）观察到胸腺树突状细胞增生和过高反应,伴有淋巴细胞大量凋亡;伤后2－3日（MODS进展期）,树突状细胞数量显著减少、形态萎缩,淋巴细胞凋亡减轻。结论：树突状细胞的病理改变不仅可能是MODS的早发病变和启动因素之一,且可能是影响全身炎症反应综合征（SIRS）或代偿性抗炎反应综合征（CARS）形成和转归,使病程走向MODS的一种重要细胞病变。

Study on pathological changes in thymus dendritic cells and their role in multiple organ dysfunction syndrome rat and their effect on pathogenesis

Objective:To explore the role of dendritic cell (DC) in the pathogenesis of multiple organ dysfunction syndrome (MODS),and to provide a new approach in basic research and clinical treatment in sepsis and MODS after severe injury.Methods:The changes in DC and its relationship with apoptosis in the thymus of MODS rats were studied and proved by the use of light microscope and electronic microscope with immunohistochemistry (CD1a,S100) and TdTmediated dUTP nick end labeling(TUNEL).Results:In the early stage of MODS,hyperplasia and over response in DCs in the thymus,together with apoptosis in a large number of lymphocytes were observed.In the MODS stage,there appeared a decrease and atrophy in DCs and attenuation of the lymphocytes.Conclusions:The changes in DCs occurred early in the development of MODS,and it might be one of the important factors to influence the initiation and development of systemic inflammatory response syndrome (SIRS) and compensatory antiinflammatory response syndrome (CARS),thereby leading to MODS.