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血管内皮细胞损伤是创伤、感染等休克过程中最早出现和最常见的形态学变化,其机制较复杂,参与因素也较多。低分子纤维蛋白(原)降解物(Lmw FDP)可能是其损伤中有重要因素之一。本研究采用HPLC法检测了LmwFDP成分之一——FPA、FPB于烧伤后的变化规律,同时利用体外培养内皮细胞的方法,观察了烧伤血清和FPA、FPB对内皮细胞的损伤作用。本实验主要结果如下: (1)将烧伤血清和灭活补体的烧伤血清分别与内皮细胞孵育,内皮细胞变性,坏死,培养液中LDH和6-酮-PGF_(1α)含量升高。说明烧伤血清对内皮细胞有毒性作用,且此毒性不仅仅是通过补体介导的。 (2)本实验观察18例烧伤病人(TBSA为46.66±21.0％)发现:烧伤后2天,血清FPA、FPB升高,5～7天达高峰,15天开始恢复,25天接近对照水平。伤后FPA、FPB的变化与病情进展有密切关系。因而检测烧伤后血清FPA、FPB的变化,有助于了解病情。 (3)体外实验表明:FPA、FPB可损伤血管内皮细胞,其损伤作用特点如下:①不可逆性。②剂量依赖性。③特异性。上述结果表明:FPA、FPB在内皮细胞损伤中可能具有重要作用。
Vascular endothelial cell injury is the earliest and most common morphological change in the process of trauma, infection and other shocks. Its mechanism is complicated and involves many factors. Low molecular weight fibrinogen (Lmw FDP) may be one of the important factors in its damage. In this study, the changes of FPA and FPB, one of the components of LmwFDP, were detected by HPLC, and the injury of endothelial cells by burn serum, FPA and FPB was observed by culturing endothelial cells in vitro. The main results of this experiment are as follows: (1) Burn serum and inactivated complement were respectively incubated with endothelial cells for endothelial cell degeneration and necrosis. The content of LDH and 6-keto-PGF_ (1α) in the culture fluid increased. Burn serum on endothelial cells toxic effect, and this toxicity is not mediated by only complement. (2) Twenty-two burn patients (46.66 ± 21.0% TBSA) were observed in this study. The levels of serum FPA and FPB increased at 5-7 days after burn, and recovered at 15 days. The changes of FPA and FPB after injury are closely related to the progression of the disease. Therefore, detection of post-burn serum FPA, FPB changes help to understand the condition. (3) In vitro experiments show that: FPA, FPB can damage vascular endothelial cells, the role of injury are as follows: ① irreversible. ② dose-dependent. ③ specificity. The above results show that: FPA, FPB may play an important role in endothelial cell injury.