中华急诊医学杂志
中華急診醫學雜誌
중화급진의학잡지
CHINESE JOURNAL OF EMERGENCY MEDICINE
2011年
8期
807-810
,共4页
郭振辉%姜巧%陈蕊%孙杰%俞宙%肖飞%熊日成%吕凤林
郭振輝%薑巧%陳蕊%孫傑%俞宙%肖飛%熊日成%呂鳳林
곽진휘%강교%진예%손걸%유주%초비%웅일성%려봉림
脓毒症%急性肺损伤%呼吸窘迫综合征%凝血异常%组织因子%C5a反义肽
膿毒癥%急性肺損傷%呼吸窘迫綜閤徵%凝血異常%組織因子%C5a反義肽
농독증%급성폐손상%호흡군박종합정%응혈이상%조직인자%C5a반의태
Animal%Sepsis%Acute lung injury%Acute respiratory dysfunction syndrome%Coagulation%Tissue factor%CSa Anti-sense peptide
目的 观察C5a反义肽对脓毒症凝血异常及ALI发病的影响。方法 盲肠结扎穿孔复制小鼠脓毒症ALI模型，随机（随机数字法）分为健康组、假手术组、造模组和C5a反义肽干预组，分别在2，4，8，12 h时点观察肺组织损伤的病理改变和凝血指标；并采用ELISA检测血浆TF质量浓度的变化。结果 盲肠结扎穿孔后，2h后出现肺组织炎症细胞浸润、蛋白渗出和毛细血管内弥漫血栓形成，并进行性加重；而反义肽干预后的不同时间点上述病理改变均显著改善。造模组和C5a反义肽干预组，PT，TT，APTT进行性延长和DD进行性升高，而Fbg和PLT计数进行性降低，与健康组和假手术组比较P＜0.05；而与造模组比较，反义肽干预后相应时间点的各指标明显改善(P＜0.05)。TF质量浓度在健康组、假手术组分别为(42.75 ±1.25) pg/mL和(60.73±1.43) pg/mL;造模组2，4，6，12 h时点其浓度进行性升高，其中，12 h组最高为(139.81±6.17) pg/mL;而与造模组相比，反义肽组各相应时间点明显降低，12 h组为(121.41±7.21)pg/mL，各组比较有统计学意义(P＜0.05)。结论 CSa反义肽能改善脓毒症的促凝亢进与ALI/ARDS的病理改变。
目的 觀察C5a反義肽對膿毒癥凝血異常及ALI髮病的影響。方法 盲腸結扎穿孔複製小鼠膿毒癥ALI模型，隨機（隨機數字法）分為健康組、假手術組、造模組和C5a反義肽榦預組，分彆在2，4，8，12 h時點觀察肺組織損傷的病理改變和凝血指標；併採用ELISA檢測血漿TF質量濃度的變化。結果 盲腸結扎穿孔後，2h後齣現肺組織炎癥細胞浸潤、蛋白滲齣和毛細血管內瀰漫血栓形成，併進行性加重；而反義肽榦預後的不同時間點上述病理改變均顯著改善。造模組和C5a反義肽榦預組，PT，TT，APTT進行性延長和DD進行性升高，而Fbg和PLT計數進行性降低，與健康組和假手術組比較P＜0.05；而與造模組比較，反義肽榦預後相應時間點的各指標明顯改善(P＜0.05)。TF質量濃度在健康組、假手術組分彆為(42.75 ±1.25) pg/mL和(60.73±1.43) pg/mL;造模組2，4，6，12 h時點其濃度進行性升高，其中，12 h組最高為(139.81±6.17) pg/mL;而與造模組相比，反義肽組各相應時間點明顯降低，12 h組為(121.41±7.21)pg/mL，各組比較有統計學意義(P＜0.05)。結論 CSa反義肽能改善膿毒癥的促凝亢進與ALI/ARDS的病理改變。
목적 관찰C5a반의태대농독증응혈이상급ALI발병적영향。방법 맹장결찰천공복제소서농독증ALI모형，수궤（수궤수자법）분위건강조、가수술조、조모조화C5a반의태간예조，분별재2，4，8，12 h시점관찰폐조직손상적병리개변화응혈지표；병채용ELISA검측혈장TF질량농도적변화。결과 맹장결찰천공후，2h후출현폐조직염증세포침윤、단백삼출화모세혈관내미만혈전형성，병진행성가중；이반의태간예후적불동시간점상술병리개변균현저개선。조모조화C5a반의태간예조，PT，TT，APTT진행성연장화DD진행성승고，이Fbg화PLT계수진행성강저，여건강조화가수술조비교P＜0.05；이여조모조비교，반의태간예후상응시간점적각지표명현개선(P＜0.05)。TF질량농도재건강조、가수술조분별위(42.75 ±1.25) pg/mL화(60.73±1.43) pg/mL;조모조2，4，6，12 h시점기농도진행성승고，기중，12 h조최고위(139.81±6.17) pg/mL;이여조모조상비，반의태조각상응시간점명현강저，12 h조위(121.41±7.21)pg/mL，각조비교유통계학의의(P＜0.05)。결론 CSa반의태능개선농독증적촉응항진여ALI/ARDS적병리개변。
Objective To investigate the effects of C 5a anti-sense peptide on the pathogenesis of sepsis -induced abnormal coagulation and acute lung injury (ALI) in the early stage of sepsis. Methods The method of cecal ligature and puncture (CLP) was used to establish sepsis modeL Mice were randomly (random number) divided into control group, sham operation group, model group and C5a anti-sense peptide treatment group. In each group, pathological changes of the lung tissue and coagulation marker of mice were observed at intervals of 2 h, 4 h, 8 h and 12 hours after CLP. Meanwhile, the blood levels of tissue factor (TF) were detected by using ELISA at various intervals. Results The microscopicexamination showed that inflammatory cell infiltration, fibrin exudation and DIC occurred in lung tissue of mice in model group 2 hours after CLP, and those changes significantly lessened in mice of the treatment group. The levels of PT, TT, APTT and fragment D-dimer (DD) were significantly increased as time consumed, while fibrinogen (Fbg) and platelet (PLT) gradually and significantly decreased in model group and treatment group compared with control group and sham operation group ( P ＜ 0. 05 ), and those changes were greatly minimized in the treatment group than those in model group ( P ＜ 0. 05 ). The level of TF was (42.75±1.25) pg/mL in mice of control group and (60.73 ±1.43 ) pg/mL in mice of sham operation group. The level of TF of mice in model group gradually increased as time consumed to reach the highest level of ( 139. 81 ± 6. 71 ) pg/mL in 12 hours. Compared with model group, TF was ( 121.41 ± 7.21 )pg/mL in the intervention group (P ＜ 0. 05 ). Conclusions C5a anti-sense peptide can lessen the coagulation hyperactivity and ALL/ARDS symptoms in the early stage of sepsis.
