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目的探讨集合淋巴结(PP结)及其淋巴细胞在实验性末端回肠炎发病中的变化及其意义。方法选用清洁级SD大鼠,随机分为造模组、缝线组、对照组,每组30只,分别予以回肠末端-盲肠侧侧吻合术、回肠末端缝手术线、仅麻醉不手术的处理。术后2、4、8周分批处死大鼠,取末端回肠组织,分别观察其病理学改变,及PP结及其淋巴细胞增殖和凋亡的情况并分析。结果 (1)造模组2、4周PP结个数和PP结淋巴细胞总数显著增加,8周时少量增加。(2)造模组2、4周PP结淋巴细胞少量凋亡,8周时大量凋亡,PP结淋巴细胞增殖情况与PP结个数变化相似。(3)造模组与缝线组8周均出现凋亡DNA的特征性“梯形”条带,且造模组200bp条带较缝线组明显。结论在实验性末端回肠炎造模2～8周内,PP结及其淋巴细胞呈现先增殖为主、后凋亡为主的变化。因此推测,持续的免疫反应在末端回肠炎发病过程中起着不可忽视的作用。
Objective To investigate the significance of collecting lymph nodes (PP) and its lymphocytes in the pathogenesis of experimental terminal ileitis. Methods Clean SD rats were randomly divided into model group, suture group and control group, with 30 rats in each group. The animals were treated with ileal distal - cecum lateral anastomosis, distal ileal surgical suture, and only anesthesia without operation . The rats were sacrificed at 2, 4, and 8 weeks after operation, and the terminal ileum tissues were harvested. The pathological changes and the proliferation and apoptosis of PP junctions and their lymphocytes were observed and analyzed. Results (1) The number of PP junction and the total number of lymphocytes in PP junction increased significantly at 2 and 4 weeks in model group, with a slight increase at 8 weeks. (2) A few apoptotic PP lymphocytes were found in 2 and 4 weeks in model group, and a large amount of apoptosis occurred at 8 weeks. The proliferation of PP lymphocytes was similar to that of PP. (3) The characteristic “trapezoidal” bands of apoptotic DNA appeared in both the model group and the suture group for 8 weeks, and the 200 bp band of the model group was more obvious than the suture group. Conclusions Within 2 to 8 weeks of experimental terminal ileitis, the changes of PP junctions and their lymphocytes predominately proliferate first and apoptosis later. Therefore, it is speculated that the continuous immune response plays an important role in the pathogenesis of terminal ileitis.