For comparative examination of the pathological findings in burn shock and hemorrhagic shock, histological and immunohistochemical investigations of the lungs were performed. Histological specimens of 30 cases each were examined by means of immunohistological staining with P-selectin, von Willebrand factor (vWF) and PECAM-1. The results showed statistically significant differences between the two groups. There was strong staining for P-selectin (especially in the lumina of the blood vessels) and vWF (especially in the endothelium of medium-sized blood vessels) in the specimens of burn shock fatalities. In cases of rapid death after exposure to fire the strong expression of adhesion molecules, which are mainly responsible for the initial inflammatory reaction of leucocytes and platelets in burn shock, suggests prompt activation of inflammatory cells in the lung tissue. In cases of hemorrhagic shock, this reaction was much less distinct in the early stages. The same is true of the expression of PECAM-1, which was lower in lungs from burn shock fatalities than in those from hemorrhagic shock fatalities. The low expression of PECAM-1 in burn shock is a clue to the migration/diapedesis of leucocytes into the areas of burn damage. In total, the results of the investigation indicate different pathophysiological processes even in the very early stages of burn shock and hemorrhagic shock.

译文

为了比较烧伤休克和失血性休克的病理结果,进行了肺部的组织学和免疫组织化学检查。分别用P-选择素,血管性血友病因子 (vWF) 和PECAM-1进行免疫组织学染色,检查了30例的组织学标本。结果显示,两组间差异有统计学意义。在烧伤休克死亡标本中,P-选择素 (尤其是在血管腔中) 和vWF (尤其是在中型血管的内皮中) 染色强烈。在暴露于火后迅速死亡的情况下,粘附分子的强烈表达主要负责烧伤休克中白细胞和血小板的初始炎症反应,表明肺组织中炎性细胞迅速激活。在失血性休克的情况下,这种反应在早期阶段就不那么明显了。PECAM-1的表达也是如此,烧伤休克死亡的肺比失血性休克死亡的肺低。烧伤休克中PECAM-1的低表达是白细胞向烧伤损伤区域迁移/渗透的线索。总的来说,研究结果表明,即使在烧伤休克和失血性休克的早期阶段,也存在不同的病理生理过程。

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