浙江医学
浙江醫學
절강의학
ZHEJIANG MEDICAL JOURNAL
2014年
21期
1760-1763,1822
,共5页
赵圣刚%张冉%陈善浆%江力勤
趙聖剛%張冉%陳善漿%江力勤
조골강%장염%진선장%강력근
糖尿病%高脂血症%糖尿病肾病%糖尿病心肌病
糖尿病%高脂血癥%糖尿病腎病%糖尿病心肌病
당뇨병%고지혈증%당뇨병신병%당뇨병심기병
Diabetes mel itus%Lipid abnormality%Diabetic nephropathy%Diabetic cardiomyopathy
目的探讨1型糖尿病对血脂代谢及肾和心脏组织结构的影响。方法随机选取新西兰大白兔36只，分为糖尿病组（DM，20只）和对照组（NC，16只），两次四氧嘧啶（ALX，80mg/kg）耳缘静脉注射复制1型糖尿病模型，期间进行血糖控制。饲养4周，观察兔一般情况，4周末采血检测血脂变化，包括TG、TC、LDL- C、HDL- C水平、载脂蛋白（Apo）A1、ApoB100、ApoE，处死兔后膀胱穿刺抽取尿液检测尿常规和尿蛋白定量，分离心脏和肾脏进行病理组织检查。结果实验造模成功率为55%，死亡率为40%。DM组TC、HDL- C、LDL- C水平显著高于NC组（P＜0.01），其中TC、TG、LDL- C水平较NC组分别升高97%,48%,130%。DM组TC/HDL- C, LDL- C/HDL- C水平高于NC组（P＜0.01），但TG/HDL- C水平低于NC组；两组ApoB100、ApoA1/ApoB100、ApoE差异无统计学意义（均P＞0.05）。DM组尿蛋白定量较NC组升高。DM组心肌病理检查出现轻度-中-重度不同程度的心内膜下脂肪变性和沉积，肾脏病理检查提示肾小球血管袢分叶数量增加，基底膜及系膜基质增生，肾小球体积缩小，部分出现脂肪变替代，肾小管出现不同程度范围变性甚至坏死，腔内可见钙盐沉积。结论1型糖尿病可导致脂质代谢紊乱，引起心脏和肾脏病变，需行积极降脂治疗。
目的探討1型糖尿病對血脂代謝及腎和心髒組織結構的影響。方法隨機選取新西蘭大白兔36隻，分為糖尿病組（DM，20隻）和對照組（NC，16隻），兩次四氧嘧啶（ALX，80mg/kg）耳緣靜脈註射複製1型糖尿病模型，期間進行血糖控製。飼養4週，觀察兔一般情況，4週末採血檢測血脂變化，包括TG、TC、LDL- C、HDL- C水平、載脂蛋白（Apo）A1、ApoB100、ApoE，處死兔後膀胱穿刺抽取尿液檢測尿常規和尿蛋白定量，分離心髒和腎髒進行病理組織檢查。結果實驗造模成功率為55%，死亡率為40%。DM組TC、HDL- C、LDL- C水平顯著高于NC組（P＜0.01），其中TC、TG、LDL- C水平較NC組分彆升高97%,48%,130%。DM組TC/HDL- C, LDL- C/HDL- C水平高于NC組（P＜0.01），但TG/HDL- C水平低于NC組；兩組ApoB100、ApoA1/ApoB100、ApoE差異無統計學意義（均P＞0.05）。DM組尿蛋白定量較NC組升高。DM組心肌病理檢查齣現輕度-中-重度不同程度的心內膜下脂肪變性和沉積，腎髒病理檢查提示腎小毬血管袢分葉數量增加，基底膜及繫膜基質增生，腎小毬體積縮小，部分齣現脂肪變替代，腎小管齣現不同程度範圍變性甚至壞死，腔內可見鈣鹽沉積。結論1型糖尿病可導緻脂質代謝紊亂，引起心髒和腎髒病變，需行積極降脂治療。
목적탐토1형당뇨병대혈지대사급신화심장조직결구적영향。방법수궤선취신서란대백토36지，분위당뇨병조（DM，20지）화대조조（NC，16지），량차사양밀정（ALX，80mg/kg）이연정맥주사복제1형당뇨병모형，기간진행혈당공제。사양4주，관찰토일반정황，4주말채혈검측혈지변화，포괄TG、TC、LDL- C、HDL- C수평、재지단백（Apo）A1、ApoB100、ApoE，처사토후방광천자추취뇨액검측뇨상규화뇨단백정량，분리심장화신장진행병리조직검사。결과실험조모성공솔위55%，사망솔위40%。DM조TC、HDL- C、LDL- C수평현저고우NC조（P＜0.01），기중TC、TG、LDL- C수평교NC조분별승고97%,48%,130%。DM조TC/HDL- C, LDL- C/HDL- C수평고우NC조（P＜0.01），단TG/HDL- C수평저우NC조；량조ApoB100、ApoA1/ApoB100、ApoE차이무통계학의의（균P＞0.05）。DM조뇨단백정량교NC조승고。DM조심기병리검사출현경도-중-중도불동정도적심내막하지방변성화침적，신장병리검사제시신소구혈관번분협수량증가，기저막급계막기질증생，신소구체적축소，부분출현지방변체대，신소관출현불동정도범위변성심지배사，강내가견개염침적。결론1형당뇨병가도치지질대사문란，인기심장화신장병변，수행적겁강지치료。
Objective To investigate the changes of lipid metabolism, renal and cardiac histology in type 1 diabetes. Methods Thirty six New Zealand rabbits were randomly divided into diabetes mel itus group (DM, n=20) and normal control group (NC, n=16). Type 1 diabetes was induced by injection of Al oxan(80mg/kg) twice via ear marginal venous, the same vol-ume of normal saline was injected in NC group. The general conditions, body weight, food and water intake were observed for 4 weeks after injection; blood total cholesterol (TC), triglyceride (TG), low density lipoprotein cholesterol (LDL- C), high density lipoprotein cholesterol(HDL- C), apolipoprotein A(apoA), apolipoprotein B(apoB) and apolipoprotein E(apoE) levels were deter-mined, and routine urine test, urine protein were measured by the end of the experiment; and histopathological examination of heart and renal were performed. Results The TC, HDL- C, LDL- C levels and TC/HDL- C, LDL- C/HDL- C in DM group were significantly higher than those in NC group (P<0.01), but there was no significant difference in ApoB100 levels and ApoA1/ApoB100 between two groups. Compared to NC group the levels of TC, TG, LDL- C in DM group were elevated by 97%, 48%and 130%, respectively;there were no statistical differences in the ratio of TG/HDL- C and ApoE level between two groups. The urine protein level in DM group was higher than that in NC group. Histopathological examination showed that there were cel edema, disordered arrangement of myocardial fibers, interstitial enlargement, mild- moderate- severe lipid accumulation and fatty degeneration under the epicardium in the heart of DM group. Basement membrane and mesangial matrix proliferation, glomerular volume shrinking and glomerular fatty degeneration, mild- moderate- severe tubular degeneration and necrosis, cal-cium salt deposits were observed in the cavity of distal convoluted tubule in diabetic kidney. Conclusion Type 1 diabetes may result in dyslipidemia and heart and kidney dysfunction, which are associated with pathogenesis of diabetic nephropathy and cardiomyopathy.
