开腹手术与腹腔镜手术对小鼠腹腔巨噬细胞杀菌活力的不同影响及意义

发布时间：2018-10-05 17:00

【摘要】：目的：手术创伤可导致术后免疫抑制,大大降低了机体对细菌的抵抗力,使得术后机体很容易发生感染等并发症。吞噬作用是宿主固有免疫抵御外来入侵病原微生物的一个关键因素。巨噬细胞作为固有免疫中主要的吞噬细胞,通过多种吞噬受体如Fcγ受体(FcγR)、补体受体(CR)等的作用来检测入侵的病原体,并与病原体相结合,激活一系列的细胞内信号传导通路最终清除了入侵机体病原微生物以及损伤处组织和细胞的坏死碎片。本研究的主要目的是比较开腹手术与腹腔镜手术对小鼠腹腔巨噬细胞细菌吞噬作用的影响,并进一步探讨开腹手术是否比腹腔镜手术更易导致术后感染的增加。材料和方法：SPF级、健康、8-10周成年BLAB/C小鼠,随机数字表法分成三组,对照组(n=70),开腹手术组(n=70),腹腔镜手术组(n=70)。用FACS分析巨噬细胞吞噬受体的表达情况,观察3组巨噬细胞对金黄色葡萄球菌和大肠杆菌的摄取,吞噬和细胞内杀灭情况,并评估3组小鼠对活的大肠杆菌和金黄色葡萄球菌的易感情况。结果：与腹腔镜组手术相比,开腹手术组小鼠的巨噬细胞表面CR3的表达水平明显下调,从而减少了巨噬细胞对大肠杆菌和金黄色葡萄球菌的摄取和吞噬作用。同时我们还发现,在相同的感染情况下,开腹手术组的小鼠在发生感染时血液和重要脏器的细菌清除能力明显低于对照组,而腹腔镜手术组小鼠腹腔巨噬细胞对细菌的清除能力未见明显异常。结论：开腹手术后腹腔巨噬细胞对细菌的摄取、吞噬和细胞内杀菌能力降低,从而影响了机体的固有免疫功能,大大增加了术后病原微生物入侵的风险,使机体术后易于出现感染这一并发症,而腹腔镜手术对术后巨噬细胞的杀菌能力影响不大甚至有增强作用,从而减轻了术后免疫抑制的程度,降低了术后感染的发生。
[Abstract]:Objective: surgical trauma can lead to postoperative immunosuppression, greatly reduce the body's resistance to bacteria, make the body prone to infection and other complications. Phagocytosis is a key factor for host innate immunity to resist foreign invasion of pathogenic microorganisms. As the main phagocytes in innate immunity, macrophages can be used to detect and bind to invading pathogens through the action of many phagocytic receptors such as Fc 纬 receptor (Fc 纬 R), complement receptor (CR). Activation of a series of intracellular signal transduction pathways eventually clears invading pathogenic microorganisms and necrotic fragments of damaged tissues and cells. The main purpose of this study was to compare the effects of laparotomy and laparoscopy on the phagocytosis of macrophages in mice, and to explore whether laparotomy is more likely than laparoscopy to increase postoperative infection. Materials and methods BLAB/C mice were randomly divided into three groups: control group (n = 70), open operation group (n = 70), laparoscopic operation group (n = 70). The expression of phagocytic receptors in macrophages was analyzed by FACS. The uptake, phagocytosis and cytotoxicity of Staphylococcus aureus and Escherichia coli were observed in three groups of macrophages. The susceptibility of three groups to live Escherichia coli and Staphylococcus aureus was evaluated. Results: compared with laparoscopic group, the expression level of CR3 on macrophage in open operation group was significantly down-regulated, which reduced the uptake and phagocytosis of Escherichia coli and Staphylococcus aureus by macrophage. At the same time, we also found that under the same infection condition, the bacteria clearance ability of blood and important organs in the open operation group was significantly lower than that in the control group at the time of infection. However, the peritoneal macrophages in the laparoscopic group had no obvious abnormality in bacterial clearance. Conclusion: the bacterial uptake, phagocytosis and intracellular bactericidal ability of peritoneal macrophages were decreased after laparotomy, which affected the innate immune function of the body and increased the risk of invading pathogenic microorganisms after operation. The complication of infection is easy to occur after operation, while laparoscopic surgery has little or no effect on the bactericidal ability of macrophages after operation, thus reducing the degree of postoperative immunosuppression and reducing the incidence of postoperative infection.
【学位授予单位】：苏州大学
【学位级别】：硕士
【学位授予年份】：2012
【分类号】：R726.1

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