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
7期
401-404,前插1
,共5页
赵擎宇%王浩渊%张文筱%孙月丽%郑毅
趙擎宇%王浩淵%張文篠%孫月麗%鄭毅
조경우%왕호연%장문소%손월려%정의
脓毒症%多烯磷脂酰胆碱%炎症细胞因子%细胞间黏附分子-1%肝损害%组织病理学
膿毒癥%多烯燐脂酰膽堿%炎癥細胞因子%細胞間黏附分子-1%肝損害%組織病理學
농독증%다희린지선담감%염증세포인자%세포간점부분자-1%간손해%조직병이학
Sepsis%Polyenylphosphatidyl choline%Inflammatory cytokine%Intercellular adhesion molecule-1%Liver damage%Histopathology
目的 观察多烯磷脂酰胆碱(PPC)对脓毒症大鼠肝脏的保护作用.方法 将50只健康雄性SD 大鼠按随机数字表法分为正常对照组(10只)、模型组(15只)、PPC对照组(10只)和PPC保护组(15只).通过腹腔注射单剂大肠杆菌脂多糖(LPS)6 mg/kg建立脓毒症大鼠模型;正常对照组和PPC对照组给予等量生理盐水.PPC对照组和PPC保护组在注射LPS前24 h和6 h分别通过大鼠尾静脉给予等倍稀释的PPC 10 ml/kg(232.5 mg/kg);正常对照组和模型组给予等量的5%葡萄糖溶液.观察注射LPS后24 h内各组大鼠的行为改变和死亡率;处死动物后取静脉血检测丙氨酸转氨酶(ALT)和天冬氨酸转氨酶(AST);留取肝脏测定大鼠全肝重/体重比值(L/Wb)和肝湿重/干重比值(W/D),并行组织病理学检查,用免疫组化二步法检测肝组织中细胞间黏附分子-1(ICAM-1)的表达.结果 正常对照组和PPC对照组大鼠精神状态正常;模型组大鼠精神萎靡,饮水、活动少;PPC保护组精神状态较好,饮水、活动较好.PPC保护组大鼠死亡率明显低于模型组[6.7%(1/15)比46.7 %(7/15),P<0.05].PPC保护组血浆ALT和AST水平、L/Wb比值、W/D 比值及肝组织ICAM-1阳性率均低于模型组[ALT(U/L):157.71±32.63比225.63±43.47;AST(U/L):53.21±13.85比85.25±18.91;L/Wb比值:(4.09±0.28)%比(4.50±0.25)%;W/D比值:3.52±0.27比3.84±0.18;ICAM-1阳性率:35.7%(5/14)比87.5%(7/8),P<0.05或P<0.01].正常对照组与PPC对照组上述指标未见统计学差异.模型组大鼠肝脏炎症反应强烈,炎性细胞聚集,肝实质细胞水肿渗出明显;正常对照组和PPC对照组肝脏形态正常;而PPC保护组介于两者之间.结论 大鼠预防性注射PPC能阻止内毒素引起的进行性炎症紊乱,减轻肝脏水肿和炎症反应,减少肝脏ICAM-1的表达,保护肝功能,并降低死亡率.
目的 觀察多烯燐脂酰膽堿(PPC)對膿毒癥大鼠肝髒的保護作用.方法 將50隻健康雄性SD 大鼠按隨機數字錶法分為正常對照組(10隻)、模型組(15隻)、PPC對照組(10隻)和PPC保護組(15隻).通過腹腔註射單劑大腸桿菌脂多糖(LPS)6 mg/kg建立膿毒癥大鼠模型;正常對照組和PPC對照組給予等量生理鹽水.PPC對照組和PPC保護組在註射LPS前24 h和6 h分彆通過大鼠尾靜脈給予等倍稀釋的PPC 10 ml/kg(232.5 mg/kg);正常對照組和模型組給予等量的5%葡萄糖溶液.觀察註射LPS後24 h內各組大鼠的行為改變和死亡率;處死動物後取靜脈血檢測丙氨痠轉氨酶(ALT)和天鼕氨痠轉氨酶(AST);留取肝髒測定大鼠全肝重/體重比值(L/Wb)和肝濕重/榦重比值(W/D),併行組織病理學檢查,用免疫組化二步法檢測肝組織中細胞間黏附分子-1(ICAM-1)的錶達.結果 正常對照組和PPC對照組大鼠精神狀態正常;模型組大鼠精神萎靡,飲水、活動少;PPC保護組精神狀態較好,飲水、活動較好.PPC保護組大鼠死亡率明顯低于模型組[6.7%(1/15)比46.7 %(7/15),P<0.05].PPC保護組血漿ALT和AST水平、L/Wb比值、W/D 比值及肝組織ICAM-1暘性率均低于模型組[ALT(U/L):157.71±32.63比225.63±43.47;AST(U/L):53.21±13.85比85.25±18.91;L/Wb比值:(4.09±0.28)%比(4.50±0.25)%;W/D比值:3.52±0.27比3.84±0.18;ICAM-1暘性率:35.7%(5/14)比87.5%(7/8),P<0.05或P<0.01].正常對照組與PPC對照組上述指標未見統計學差異.模型組大鼠肝髒炎癥反應彊烈,炎性細胞聚集,肝實質細胞水腫滲齣明顯;正常對照組和PPC對照組肝髒形態正常;而PPC保護組介于兩者之間.結論 大鼠預防性註射PPC能阻止內毒素引起的進行性炎癥紊亂,減輕肝髒水腫和炎癥反應,減少肝髒ICAM-1的錶達,保護肝功能,併降低死亡率.
목적 관찰다희린지선담감(PPC)대농독증대서간장적보호작용.방법 장50지건강웅성SD 대서안수궤수자표법분위정상대조조(10지)、모형조(15지)、PPC대조조(10지)화PPC보호조(15지).통과복강주사단제대장간균지다당(LPS)6 mg/kg건립농독증대서모형;정상대조조화PPC대조조급여등량생리염수.PPC대조조화PPC보호조재주사LPS전24 h화6 h분별통과대서미정맥급여등배희석적PPC 10 ml/kg(232.5 mg/kg);정상대조조화모형조급여등량적5%포도당용액.관찰주사LPS후24 h내각조대서적행위개변화사망솔;처사동물후취정맥혈검측병안산전안매(ALT)화천동안산전안매(AST);류취간장측정대서전간중/체중비치(L/Wb)화간습중/간중비치(W/D),병행조직병이학검사,용면역조화이보법검측간조직중세포간점부분자-1(ICAM-1)적표체.결과 정상대조조화PPC대조조대서정신상태정상;모형조대서정신위미,음수、활동소;PPC보호조정신상태교호,음수、활동교호.PPC보호조대서사망솔명현저우모형조[6.7%(1/15)비46.7 %(7/15),P<0.05].PPC보호조혈장ALT화AST수평、L/Wb비치、W/D 비치급간조직ICAM-1양성솔균저우모형조[ALT(U/L):157.71±32.63비225.63±43.47;AST(U/L):53.21±13.85비85.25±18.91;L/Wb비치:(4.09±0.28)%비(4.50±0.25)%;W/D비치:3.52±0.27비3.84±0.18;ICAM-1양성솔:35.7%(5/14)비87.5%(7/8),P<0.05혹P<0.01].정상대조조여PPC대조조상술지표미견통계학차이.모형조대서간장염증반응강렬,염성세포취집,간실질세포수종삼출명현;정상대조조화PPC대조조간장형태정상;이PPC보호조개우량자지간.결론 대서예방성주사PPC능조지내독소인기적진행성염증문란,감경간장수종화염증반응,감소간장ICAM-1적표체,보호간공능,병강저사망솔.
Objective To investigate the protective effect of polyenylphosphatidyl choline(PPC)on liver in rat with sepsis.Methods A total of 50 healthy male SD rats were randomly divided into four groups according to random number table:normal control group(NS group,n=10),sepsis model group(LPS group,n=15),PPC control group(PPC group,n=10)and PPC protection group(P+L group,n=15).Asingle dose of lipopolysaccharide(LPS)6 mg/kg was injected to the peritoneal cavity to reproduce the sepsis model,while in NS group and PPC group,same volume of normal saline was used.PPC 10 ml/kg (232.5 mg/kg)was injected 24 hours and 6 hours before LPS via the tail vein in PPC group and P+L group,while in NS group and LPS group 5%glucose solution in the same volume was given.Behavioral changes and mortality rate of rats were recorded,and all survived rats were sacrificed 24 hours after LPS injection.Venous blood was taken for alanine aminotransferase(ALT)and aspartate aminotransferase(AST)determination.Ratios of liver weight/body weight(L/Wb)and wet wieght/dry weight of liver(W/D)were calculated.Histopathology changes in liver tissue were observed with hematoxylin eosin(HE)stain,and intercellular adhesion molecule-1(ICAM-1)expression with instant two-step immunohistochemistry.Results Twenty-four hours after LPS injection(LPS group),the rats became lethargic,with less activity and drinking,while rats in P+L group,showed much better mental status,water intake and activity than LPS group.The mortality rate of P+L group was significantly lower than that of LPS group[6.7%(1/15)vs.46.7%(7/15),P<0.05].Compared with LPS group,rats in P+L group had lower levels of plasma ALT and AST,L/Wb,W/D,and liver ICAM-1 positive expression ratio[ALT(U/L):157.71±32.63 vs.225.63±43.47; AST(U/L): 53.21±13.85 vs.85.25±18.91;L/Wb:(4.09±0.28)%vs.(4.50±0.25)%,W/D:3.52±0.27 vs.3.84±0.18,ICAM-1 positive expression ratio:35.7%(5/14)vs.87.5(7/8),P<0.05 or P<0.01].All parameters were normal in NS group and PPC group,and no statistical significance was observed between them(all P>0.05).LPS-injection led to severe inflammatory reaction in hepatic tissue,including obvious edema of hepatic parenchymal cells,exudation and aggregation of inflammatory cells,while in P+L group,these morphological changes were milder than that in LPS group but more obvious than that of NS group.Conclusion Pre-treatment of rats with PPC alleviates progressive inflammatory disturbances of hepafic tissue caused by endotoxin injection,and it attenuates liver edema and ICAM-1 expression,protects liver function and decreases mortality rate in rats with sepsis.
