中华急诊医学杂志
中華急診醫學雜誌
중화급진의학잡지
CHINESE JOURNAL OF EMERGENCY MEDICINE
2014年
12期
1327-1332
,共6页
桑珍珍%许云%盛英杰%贾冬%金帅%张鹏思%赵敏
桑珍珍%許雲%盛英傑%賈鼕%金帥%張鵬思%趙敏
상진진%허운%성영걸%가동%금수%장붕사%조민
重组人促红细胞生成素%盲肠结扎穿孔术%脓毒症%急性肝损伤
重組人促紅細胞生成素%盲腸結扎穿孔術%膿毒癥%急性肝損傷
중조인촉홍세포생성소%맹장결찰천공술%농독증%급성간손상
Recombinant human erythropoietin%Caecal ligation and puncture%Sepsis%Acute liver injury
目的 探讨重组人促红细胞生成素(recombinant human erythropoietin,rHuEPO)对盲肠结扎穿孔术(CLP)所致大鼠急性肝损伤的保护作用.方法 96只雄性SD大鼠随机(随机数字法)分为:假CLP组(对照组),CLP组(脓毒症组),rHuEPO组.采用盲肠结扎穿孔术复制急性肝损伤的动物模型,rHuEPO组造模后即刻经尾静脉推注rHuEPO 5000U/kg.手术后连续观察24h,选择术后2h、6h、12h、24h为观察点.分别在各时点随机处死大鼠,采用酶联免疫法(ELISA法)检测血清TNF-α、iNOS水平变化;同时检测肝功能(ALT、AST);采用光镜和透射电镜观察肝组织形态学变化.结果 ①各时间点大鼠血清中ALT、AST、TNF-α、iNOS水平的变化为脓毒症组及rHuEPO组上述指标明显高于对照组;rHuEPO组与脓毒症组相比,上述指标明显降低,差异具有统计学意义(P<0.01).②光镜及电镜观察发现,脓毒症时肝脏病理学改变为局灶性肝细胞坏死,炎性细胞浸润,小叶间静脉充血扩张,肝细胞核固缩,线粒体、内质网明显减少.rHuEPO组肝脏病理学改变较CLP组明显减轻.结论 rHuEPO能够降低血清中ALT、AST、TNF-α、iNOS水平,发挥调节炎症反应进而改善肝功能的作用,对感染所致急性肝损伤具有一定的保护作用.
目的 探討重組人促紅細胞生成素(recombinant human erythropoietin,rHuEPO)對盲腸結扎穿孔術(CLP)所緻大鼠急性肝損傷的保護作用.方法 96隻雄性SD大鼠隨機(隨機數字法)分為:假CLP組(對照組),CLP組(膿毒癥組),rHuEPO組.採用盲腸結扎穿孔術複製急性肝損傷的動物模型,rHuEPO組造模後即刻經尾靜脈推註rHuEPO 5000U/kg.手術後連續觀察24h,選擇術後2h、6h、12h、24h為觀察點.分彆在各時點隨機處死大鼠,採用酶聯免疫法(ELISA法)檢測血清TNF-α、iNOS水平變化;同時檢測肝功能(ALT、AST);採用光鏡和透射電鏡觀察肝組織形態學變化.結果 ①各時間點大鼠血清中ALT、AST、TNF-α、iNOS水平的變化為膿毒癥組及rHuEPO組上述指標明顯高于對照組;rHuEPO組與膿毒癥組相比,上述指標明顯降低,差異具有統計學意義(P<0.01).②光鏡及電鏡觀察髮現,膿毒癥時肝髒病理學改變為跼竈性肝細胞壞死,炎性細胞浸潤,小葉間靜脈充血擴張,肝細胞覈固縮,線粒體、內質網明顯減少.rHuEPO組肝髒病理學改變較CLP組明顯減輕.結論 rHuEPO能夠降低血清中ALT、AST、TNF-α、iNOS水平,髮揮調節炎癥反應進而改善肝功能的作用,對感染所緻急性肝損傷具有一定的保護作用.
목적 탐토중조인촉홍세포생성소(recombinant human erythropoietin,rHuEPO)대맹장결찰천공술(CLP)소치대서급성간손상적보호작용.방법 96지웅성SD대서수궤(수궤수자법)분위:가CLP조(대조조),CLP조(농독증조),rHuEPO조.채용맹장결찰천공술복제급성간손상적동물모형,rHuEPO조조모후즉각경미정맥추주rHuEPO 5000U/kg.수술후련속관찰24h,선택술후2h、6h、12h、24h위관찰점.분별재각시점수궤처사대서,채용매련면역법(ELISA법)검측혈청TNF-α、iNOS수평변화;동시검측간공능(ALT、AST);채용광경화투사전경관찰간조직형태학변화.결과 ①각시간점대서혈청중ALT、AST、TNF-α、iNOS수평적변화위농독증조급rHuEPO조상술지표명현고우대조조;rHuEPO조여농독증조상비,상술지표명현강저,차이구유통계학의의(P<0.01).②광경급전경관찰발현,농독증시간장병이학개변위국조성간세포배사,염성세포침윤,소협간정맥충혈확장,간세포핵고축,선립체、내질망명현감소.rHuEPO조간장병이학개변교CLP조명현감경.결론 rHuEPO능구강저혈청중ALT、AST、TNF-α、iNOS수평,발휘조절염증반응진이개선간공능적작용,대감염소치급성간손상구유일정적보호작용.
Objective To investigate the protective effects of recombinant human erythropoietin (rHuEPO) on caecal ligation and puncture (CLP)-induced acute liver injury.Methods Ninety-six healthy male Sprague-Dawley rats weighing 250-300 g were randomly divided into 3 groups:normal control group (sham group,n =32),CLP model group (sepsis group,n =32) and rHuEPO treatment group (n =32).The rat model of sepsis was established by caecal ligation and puncture.In treatment group,rats were treated with rHuEPO 5000 U/kg administered through caudalis vein after CLP procedure.Continuous observation was carried out until 24 h after modeling.Of each group,8 rats were sacrificed at 2 h,6 h,12 h and 24 h,respectively,and then the liver tissue samples and blood samples were collected.Blood samples were assayed for determining the levels of serum cytokines [tumor necrosis factor-alpha (TNF-α)],and inducible nitric oxide synthase (iNOS) by using the enzyme-linked immunoadsorbentassay (ELISA) method.The levels of serum alanine aminotransferase (ALT) and aspartate aminotransferase (AST) were also detected.Histopathological changes of liver tissues were observed under optical and transmission electron microscopy.Results (①)The levels of ALT,AST,TNF-a,iNOS in serum of rats in control group were lower than those in model group and rHuEPO group (P <0.01).The levels of TNF-α,IL-6 and iNOS in serum of rats in rHuEPO group were decreased significantly compared with model group (P < 0.01).(②) The optical microscopy and the transmission electron microscopy showed hepatocyte edema,liver focal necrosis,inflammatory cell infiltration in portal area and severe congestion of interlobular veins,hepatocyte karyopyknosis,mitochondrial and endoplasmic reticulum (ER) obviously decreased in sepsis group at 24 h.Hepatic injury was attenuated after employment of rHuEPO.Conclusions Recombinant human erythropoietin can inhibit the levels of ALT,AST,TNF-a,iNOS in serum,thus modifying the inflammatory response and providing protective effects against acute liver injury in the wake of infection.