CAJ | 학술논문

目的：观察大鼠腹主动脉阻断缺血再灌注术后合并脓毒症时肾脏组织病理学改变及肾脏组织中肿瘤坏死因子-α（ TNF-α）的变化。方法 SPF级 Wistar大鼠32只随机分为4组：假手术组（A组），腹主动脉阻断组（B 组），脓毒症组（C 组）及腹主动脉阻断合并脓毒症组（ D组）。所有动物于再灌注后8 h处死。4％多聚甲醛灌注固定后取肾脏，采用 HE染色光镜下对各组肾脏进行组织形态学对比观察，免疫组化法检测肾脏组织中 TNF -α的表达。结果 HE染色显示 A组无明显病理改变，B 组可见轻度损伤，C 组较 B 组病理改变严重，D组最为严重。TNF -α表达平均总面积 A、B、C、D 组依次递增，与 A 组比较，B、C、D 组均显著增加（P均＜0.05），但 B组与 C组无显著性差异（P＞0.05）；TNF-α表达平均积分光密度 A、B、D、C组依次递增，各组间有显著性差异（P均＜0.05）。结论腹主动脉阻断术后合并脓毒症时急性肾损伤最为严重，TNF-α作为一种至关重要的前炎性因子发挥了重要作用；免疫紊乱和肾脏再灌注无复流，对肾脏 TNF -α表达造成了复杂的影响。
목적：관찰대서복주동맥조단결혈재관주술후합병농독증시신장조직병이학개변급신장조직중종류배사인자-α（ TNF-α）적변화。방법 SPF급 Wistar대서32지수궤분위4조：가수술조（A조），복주동맥조단조（B 조），농독증조（C 조）급복주동맥조단합병농독증조（ D조）。소유동물우재관주후8 h처사。4％다취갑철관주고정후취신장，채용 HE염색광경하대각조신장진행조직형태학대비관찰，면역조화법검측신장조직중 TNF -α적표체。결과 HE염색현시 A조무명현병리개변，B 조가견경도손상，C 조교 B 조병리개변엄중，D조최위엄중。TNF -α표체평균총면적 A、B、C、D 조의차체증，여 A 조비교，B、C、D 조균현저증가（P균＜0.05），단 B조여 C조무현저성차이（P＞0.05）；TNF-α표체평균적분광밀도 A、B、D、C조의차체증，각조간유현저성차이（P균＜0.05）。결론복주동맥조단술후합병농독증시급성신손상최위엄중，TNF-α작위일충지관중요적전염성인자발휘료중요작용；면역문란화신장재관주무복류，대신장 TNF -α표체조성료복잡적영향。
Objective It is to observe the pathmorphological changes of kidney tissues and the expression of TNF -α in kidney tissues of rats with ischemic reperfusion injury complicated with sepsis after abdominal aorta champing( AAC). Meth-ods Thirty-two Wistar rats of SPF were randomly divided into four groups:control group( group A),abdominal aorta cham-ping group( group B),sepsis group( group C),and abdominal aorta champing complicated with sepsis group( group D). All animals were killed 8 hours after the reperfusion. The pathomorphological changes in Kidney tissues were observed with HE method,and the TNF-α expression was detection by immunohistochemistty methods. Results There was no obviously patho-logical changes in group A,and was slight pathological changes in group B,the pathological changes in group C was more seri-ous than group B,the pathological changes was most serious in group D. The expression area of TNF- α was increased from group A to D,the amount of group A was least among the four groups(all P<0. 05),but there was no significant differences between group B and C(P>0. 05);the average integral optical density of TNF- α was increased from group A to D,there were significant differences among the four groups(all P<0. 05). Conclusion The kidney injury is worst in AAC complicated with sepsis,TNF- α play an important role as a vital pro-inflammatory cytokines;the expression of TNF- α is affected by the immunologic derangement and reperfusion.