中国危重病急救医学
中國危重病急救醫學
중국위중병급구의학
CHINESE CRITICAL CARE MEDICINE
2011年
5期
286-289
,共4页
脓毒症%盲肠结扎穿孔术%下丘脑-垂体-肾上腺轴%透射电镜
膿毒癥%盲腸結扎穿孔術%下丘腦-垂體-腎上腺軸%透射電鏡
농독증%맹장결찰천공술%하구뇌-수체-신상선축%투사전경
Sepsis%Cecal ligation and puncture%Hypothalamic-pituitary-adrenal axis%Trans-mission electron microscopy
目的 观察脓毒症早期下丘脑-垂体-肾上腺(HPA)轴结构及功能的变化,并探讨其相互关系.方法 雄性SD大鼠30只,按随机数字表法均分为正常对照组、假手术组和脓毒症组.采用盲肠结扎穿孔术(CLP)制作脓毒症大鼠模型,术后6 h取血并处死动物,检测血浆促肾上腺皮质激素(ACTH)、皮质酮(CoRT)以及下丘脑促肾上腺皮质激素释放激素(CRH)水平;透射电镜下观察HPA轴的超微结构改变.结果 脓毒症组血浆ACTH、CORT和下丘脑CRH水平均明显高于正常对照组和假手术组[ACTH(pmol/L):5.78±0.36比1.94±0.31、2.51±0.10;CORT(nmol/L):88.48±4.47比22.02±1.62、34.20±2.51,CRH(μg/L):101.92±6.61比61.65±6.05、66.65±4.03,P＜0.05或P＜0.01].透射电镜下观察:脓毒症组大鼠下丘脑粗面内质网囊状扩张、脱颗粒,高尔基体肿胀,垂体ACTH细胞分泌颗粒增多,肾上腺组织脂滴减少.结论 脓毒症早期大鼠HPA轴处于过度激活状态,血浆ACTH、CORT和下丘脑CRH水平明显升高;HPA轴的超微结构明显改变,且与功能变化有密切联系.
目的 觀察膿毒癥早期下丘腦-垂體-腎上腺(HPA)軸結構及功能的變化,併探討其相互關繫.方法 雄性SD大鼠30隻,按隨機數字錶法均分為正常對照組、假手術組和膿毒癥組.採用盲腸結扎穿孔術(CLP)製作膿毒癥大鼠模型,術後6 h取血併處死動物,檢測血漿促腎上腺皮質激素(ACTH)、皮質酮(CoRT)以及下丘腦促腎上腺皮質激素釋放激素(CRH)水平;透射電鏡下觀察HPA軸的超微結構改變.結果 膿毒癥組血漿ACTH、CORT和下丘腦CRH水平均明顯高于正常對照組和假手術組[ACTH(pmol/L):5.78±0.36比1.94±0.31、2.51±0.10;CORT(nmol/L):88.48±4.47比22.02±1.62、34.20±2.51,CRH(μg/L):101.92±6.61比61.65±6.05、66.65±4.03,P＜0.05或P＜0.01].透射電鏡下觀察:膿毒癥組大鼠下丘腦粗麵內質網囊狀擴張、脫顆粒,高爾基體腫脹,垂體ACTH細胞分泌顆粒增多,腎上腺組織脂滴減少.結論 膿毒癥早期大鼠HPA軸處于過度激活狀態,血漿ACTH、CORT和下丘腦CRH水平明顯升高;HPA軸的超微結構明顯改變,且與功能變化有密切聯繫.
목적 관찰농독증조기하구뇌-수체-신상선(HPA)축결구급공능적변화,병탐토기상호관계.방법 웅성SD대서30지,안수궤수자표법균분위정상대조조、가수술조화농독증조.채용맹장결찰천공술(CLP)제작농독증대서모형,술후6 h취혈병처사동물,검측혈장촉신상선피질격소(ACTH)、피질동(CoRT)이급하구뇌촉신상선피질격소석방격소(CRH)수평;투사전경하관찰HPA축적초미결구개변.결과 농독증조혈장ACTH、CORT화하구뇌CRH수평균명현고우정상대조조화가수술조[ACTH(pmol/L):5.78±0.36비1.94±0.31、2.51±0.10;CORT(nmol/L):88.48±4.47비22.02±1.62、34.20±2.51,CRH(μg/L):101.92±6.61비61.65±6.05、66.65±4.03,P＜0.05혹P＜0.01].투사전경하관찰:농독증조대서하구뇌조면내질망낭상확장、탈과립,고이기체종창,수체ACTH세포분비과립증다,신상선조직지적감소.결론 농독증조기대서HPA축처우과도격활상태,혈장ACTH、CORT화하구뇌CRH수평명현승고;HPA축적초미결구명현개변,차여공능변화유밀절련계.
Objective To observe the changes in ultrastructure and function of hypothalamicpituitary-adrenal axis (HPAA), and to approach the relationship between them in early stage of sepsis in rats. Methods Thirty male Sprague-Dawley (SD) rats were randomly divided into normal control group,sham group, sepsis group. The sepsis model was reproduced by cecal ligation and puncture (CLP). The rats were sacrificed after collection of blood at 6 hours after CLP, and the levels of adrenocorticotropic hormone (ACTH) and corticosterone (CORT) in the plasma, and the corticotropin release hormone (CRH) in the tissue of hypothalamus were detected. The histopathological changes in HPAA were observed with transmission electron microscopy. Results The levels of ACTH and CORT in plasma, and the CRH in hypothalamus tissue of sepsis group were increased in the early stage of sepsis compared with the normal control group or sham group [ACTH (pmol/L): 5. 78 ± 0. 36 vs. 1.94 ±0.31, 2. 51 ± 0.10; CORT (nmol/L), 88.48±4.47 vs. 22.02±1.62, 34.20±2.51; CRH (μg/L): 101. 92±6. 61 vs. 61.65±6.05,66. 65±4. 03, P＜0. 05 or P＜0. 01]. The changes in ultrastructure of the hypothalamus, pituitary and adrenal were also found. In sepsis group, the ultrastructure of hypothalamus was as follows. Rough endoplasmic reticulum expansion and degranulation of rough endoplasmic reticulum, and swelling of Golgi complex were found. A large number of endocrine granules could be seen in ATCH cells in the pituitary with depletion of adrenal lipid droplets. Conclusion In septic rats, the HPAA was excessively activated, and ACTH and CORT in plasma, and CRH in hypothalamus were significantly increased in early stage of sepsis.The changes in ultrastructure of HPAA were obvious, and the change in function was closely related to the ultrastructural changes.
