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目的探讨血清类胰蛋白酶在大鼠羊水入血后的活性变化及其病理作用。方法30只雌性W istar大鼠于妊娠20 d制作羊水入血模型。根据注入液体性质不同随机分为对照组10只(注入生理盐水)、羊水组10只(注入羊水)、胎粪液组10只(注入1%胎粪液)。60 m in后处死大鼠,提取大鼠肺组织行病理学检查;采用专性底物α-N-苯甲酰-DL-精氨酸-P-硝基苯胺测定3组大鼠试验前后的血清类胰蛋白酶活性变化。结果(1)肺组织病理改变:羊水组及胎粪液组大鼠肺组织均有不同程度水肿,血管丰富,局部可见少量出血;血管及支气管周围可见大量炎性细胞浸润,主要为中性粒细胞、巨噬细胞及少量淋巴细胞;而胎粪液组上述病理改变较羊水组明显。对照组大鼠肺组织无明显病理改变。(2)血清类胰蛋白酶活性:胎粪液组及羊水组大鼠类胰蛋白酶活性实验后分别为176.4±8.6及165.4±7.4,均较实验前的146.8±8.9及147.8±9.5明显升高,两组各自实验前后比较,差异有统计学意义(P<0.01);对照组实验前后分别为145.3±10.6及146.9±9.4(P>0.05)。胎粪液组及羊水组大鼠实验后类胰蛋白酶活性较对照组明显升高,且差异具有统计学意义(P<0.05)。结论大鼠羊水入血后引起血清类胰蛋白酶活性显著升高,类胰蛋白酶可能是羊水栓塞发生的重要原因;由此引起中性粒细胞、巨噬细胞浸润及肺损伤。该酶学方法灵敏、有效,在羊水栓塞诊断中有一定的应用价值。
Objective To investigate the changes of serum tryptase activity in rat amniotic fluid and its pathological effects. Methods Thirty female Wistar rats were injected with amniotic fluid into the blood at 20 days gestation. According to the nature of the injected liquid, the rats were randomly divided into control group (saline injection), amniotic fluid group (amniotic fluid injection) and meconium solution group (injection of 1% meconium solution). 60 m in after the rats were sacrificed, lung tissue was extracted from rats for pathological examination; specific substrate α-N-benzoyl-DL-arginine-P-nitroanilide Serum tryptase activity changes. Results (1) Pathological changes of lung tissue: The lung tissue of amniotic fluid group and meconium group had different degrees of edema, abundant blood vessels and a small amount of local bleeding. A large number of inflammatory cells infiltrated around blood vessels and bronchus, mainly neutrophils Cells, macrophages and a small amount of lymphocytes; and meconium fluid group of pathological changes than the amniotic fluid group was significantly. The control group rats lung tissue no obvious pathological changes. (2) Serum tryptase activity: The trypsin activity of the meconium and amniotic fluid groups were 176.4 ± 8.6 and 165.4 ± 7.4, respectively, which were significantly higher than those of 146.8 ± 8.9 and 147.8 ± 9.5 before the experiment, The difference between the two groups before and after the experiment was statistically significant (P <0.01); the control group before and after the experiment were 145.3 ± 10.6 and 146.9 ± 9.4 (P> 0.05). The activity of tryptase in meconium liquid group and amniotic fluid group was significantly higher than that in control group (P <0.05). Conclusions The amniotic fluid in rats induced a significant increase in serum tryptase activity. Tryptase may play an important role in the pathogenesis of amniotic fluid embolism. It induced neutrophil and macrophage infiltration and lung injury. The enzymology method is sensitive and effective, and has certain value in the diagnosis of amniotic fluid embolism.