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

:为了比较检查烧伤休克和出血性休克的病理结果,进行了肺的组织学和免疫组化研究。用P-选择蛋白,von Willebrand因子(vWF)和PECAM-1进行免疫组织染色,检查30例患者的组织学标本。结果显示两组之间在统计学上有显着差异。烧伤休克死亡标本中的P-选择蛋白(特别是在血管腔中)和vWF(特别是在中型血管内皮中)有很强的染色。在着火后迅速死亡的情况下,粘附分子的强表达主要是烧伤休克中白细胞和血小板的初始炎症反应,提示肺组织中的炎症细胞会迅速活化。在失血性休克的情况下,早期反应不明显。 PECAM-1的表达也是如此,其在烧伤性休克死亡中的肺低于在出血性休克死亡中的肺。 PECAM-1在烧伤休克中的低表达是白细胞向烧伤部位迁移/渗血的线索。总体而言,研究结果表明,即使在烧伤休克和失血性休克的早期,病理生理过程也不同。

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