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目的探讨多器官功能障碍综合征(MODS)时胰腺腺泡细胞超微结构和功能的改变。方法实验地点为福建省立医院动物房、福建省立医院心血管研究所重点实验室、福建省立医院病理科与福建医科大学电镜室。清洁级健康雄性SD大鼠20只,体重180～220g,随机分成2组,即:MODS组和对照组,每组10只。MODS组大鼠腹腔内注射大肠杆菌菌液,同时钳断大鼠左下肢,造成感染复合创伤二次打击MODS大鼠模型。对照组给予等量生理盐水腹腔内注射。48h后检测有两个以上器官或系统功能障碍即为MODS组造模成功。成功造模后,抽血测定其血清胰淀粉酶、脂肪酶,两组大鼠资料的比较用成组t检验。抽血后取标本电镜下观察两组大鼠胰腺腺泡细胞超微结构,免疫组化分析胰腺腺泡细胞Bax蛋白表达。结果和对照组比较,MODS组大鼠胰淀粉酶、脂肪酶及Bax蛋白表达明显高于正常对照组(P<0.01)。胰腺腺泡细胞出现空泡变性,少数细胞坏死,及出现线粒体肿胀,粗面内质网扩张等一系列超微结构病理改变。结论 MODS大鼠可出现胰腺损害。
Objective To investigate the ultrastructural and functional changes of pancreatic acinar cells in patients with multiple organ dysfunction syndrome (MODS). Methods The experimental sites were Animal Hospital of Fujian Provincial Hospital, Key Laboratory of Cardiovascular Research of Fujian Provincial Hospital, Department of Pathology of Fujian Provincial Hospital and Department of Electron Microscopy of Fujian Medical University. Twenty healthy male Sprague Dawley rats weighing 180-220 g were randomly divided into 2 groups: MODS group and control group, with 10 rats in each group. MODS rats were injected intraperitoneally Escherichia coli bacterial liquid, while clamping the left lower extremity of rats, resulting in infection trauma twice MODS rat model. The control group was given the same amount of saline intraperitoneal injection. 48h after the detection of two or more organs or system dysfunction is MODS group modeling success. After the success of modeling, blood was measured for serum pancreatic amylase, lipase, two groups of rats data comparison using t-test group. The ultrastructure of pancreatic acinar cells in the two groups were observed under the electromicroscopy and the expression of Bax protein in pancreatic acinar cells was detected by immunohistochemistry. Results Compared with the control group, the expression of pancreatic amylase, lipase and Bax in MODS group was significantly higher than that in the normal control group (P <0.01). Pancreatic acinar cells vacuolar degeneration, a small number of cell necrosis, and the emergence of mitochondria swelling, rough endoplasmic reticulum and a series of ultrastructural pathological changes. Conclusion MODS rats may have pancreatic lesions.