Shi Han-ping, Liu Zheng-jun, Wen Ying
Department of General Surgery, Southern Hospital, First Military Medical University, Guangzhou 510515, China.
Chin J Traumatol. 2004 Feb;7(1):36-41.
To examine whether pancreatic proteolytic enzymes involve in lung injury induced by trauma/hemorrhagic shock (T/HS).
Male Sprague-Dawley rats received intraluminal or intravenous pancreatic serine protease inhibitor, 6-amidino-2-naphthyl p-guanidinobenzoate dimethanesulfate (ANGD) during laparotomy (trauma), and were subjected to 90 minutes of T/HS or trauma-sham shock (T/SS). Degree of lung injury was assessed 3 hours after resuscitation with Ringer's lactate solution.
Lung permeability, pulmonary myeloperoxidase levels and the ratio of bronchoalveolar lavage fluid protein to plasma protein increased after T/HS, and significantly decreased in intraluminal-ANGD treated but not in intravenous-ANGD treated rats. Histological analysis demonstrated fewer injured villi in the intraluminal-ANGD treated rats compared with those in the control rats. Linear regression analysis revealed that the percentage of injured ileal mucosal villi directly related to pulmonary polymorphic neutrophil sequestration and lung permeability to Evans blue dye.
Pancreatic proteolytic enzymes in the ischemic gut may be important toxic factors contributing to lung injury after T/HS.
探讨胰腺蛋白水解酶是否参与创伤/失血性休克（T/HS）所致的肺损伤。
雄性Sprague-Dawley大鼠在剖腹术（创伤）期间接受腔内或静脉注射胰腺丝氨酸蛋白酶抑制剂6-脒基-2-萘基对胍基苯甲酸二甲磺酸盐（ANGD），并接受90分钟的T/HS或创伤-假休克（T/SS）。用乳酸林格氏液复苏3小时后评估肺损伤程度。
T/HS后肺通透性、肺髓过氧化物酶水平以及支气管肺泡灌洗液蛋白与血浆蛋白的比值升高，腔内注射ANGD治疗的大鼠上述指标显著降低，而静脉注射ANGD治疗的大鼠则无此变化。组织学分析显示，与对照大鼠相比，腔内注射ANGD治疗的大鼠受损绒毛较少。线性回归分析表明，受损回肠黏膜绒毛的百分比与肺多形核中性粒细胞滞留以及肺对伊文思蓝染料的通透性直接相关。
缺血肠道中的胰腺蛋白水解酶可能是T/HS后导致肺损伤的重要毒性因素。
