CAJ | 학술논문

目的：探讨低分子肝素对脓毒症大鼠肺血管内皮细胞功能的影响。方法采用大鼠盲肠结扎穿孔术（ CLP）复制大鼠脓毒症模型。清洁级雄性Wistar大鼠104只被随机分为正常对照组、假手术组、脓毒症模型组和低分子肝素治疗组，每组8只，其中后三组按术后处死时间分为12、24、48、72 h共4个亚组。各组分别在相应时间点处死大鼠，经腹主动脉取血进行常规检测，用酶联免疫吸附法（ ELISA）测定可溶性血栓调节蛋白（sTM）、可溶性内皮细胞蛋白C受体（sEPCR）浓度以及炎症反应可溶性 E-选择素（sE-selectin）的含量。结果正常对照组和假手术组sTM、sEPCR和sE-selectin的表达水平均无显著差异（P均＞0.05）。脓毒症模型组伤后12 h开始在各个时间点sTM、sEPCR和sE-selectin 的表达均有不同程度增高（P均＜0.05），并持续至伤后72 h；与模型组比较，低分子肝素治疗组于 CLP后12 h开始，至24、48 h，sTM、sEPCR和 sE-selectin 的表达均明显降低，并持续至72 h（P均＜0.05）。结论低分子肝素能通过对脓毒症凝血-炎症网络的调节，降低脓毒症大鼠sTM的表达水平，并降低大鼠体内sE-se-lectin的水平，从而减轻肺组织炎症损害，在一定程度上缓解脓毒症的进程。
목적：탐토저분자간소대농독증대서폐혈관내피세포공능적영향。방법채용대서맹장결찰천공술（ CLP）복제대서농독증모형。청길급웅성Wistar대서104지피수궤분위정상대조조、가수술조、농독증모형조화저분자간소치료조，매조8지，기중후삼조안술후처사시간분위12、24、48、72 h공4개아조。각조분별재상응시간점처사대서，경복주동맥취혈진행상규검측，용매련면역흡부법（ ELISA）측정가용성혈전조절단백（sTM）、가용성내피세포단백C수체（sEPCR）농도이급염증반응가용성 E-선택소（sE-selectin）적함량。결과정상대조조화가수술조sTM、sEPCR화sE-selectin적표체수평균무현저차이（P균＞0.05）。농독증모형조상후12 h개시재각개시간점sTM、sEPCR화sE-selectin 적표체균유불동정도증고（P균＜0.05），병지속지상후72 h；여모형조비교，저분자간소치료조우 CLP후12 h개시，지24、48 h，sTM、sEPCR화 sE-selectin 적표체균명현강저，병지속지72 h（P균＜0.05）。결론저분자간소능통과대농독증응혈-염증망락적조절，강저농독증대서sTM적표체수평，병강저대서체내sE-se-lectin적수평，종이감경폐조직염증손해，재일정정도상완해농독증적진정。
Objective To investigate the effects of low-dose heparin injection on pulmonary vascular endothelial cell function of sep-sis rats.Methods Sepsis model was produced by cecal ligation and puncture(CLP).104 healthy male Wistar rats were randomly divided into control,sham operation,cecal ligation and puncture(CLP) model group,and low-dose heparin-treated groups.The three latter groups were divided into four subgroups of 12,24,48 and 72 h with 8 rats in each subgroup.The blood samples of each group were collected at vari-ous time points from abdominal aorta to determine the levels of sTM,sEPCR and sE-selectin expression by enzyme linked immunosorbent as-say( ELISA) .Results The levels of STM,sEPCR and sE-selectin expressions had no significant differences among control and sham opera-tion groups(both P>0.05).STM,sEPCR and sE-selectin expressions levels were significantly increased beginning at 12 h in post-CLP(all P<0.05),and were decreased continuing at 72 h.Also,low-dose heparin dramatically decreased STM,sEPCR and sE-selectin levels at 12 h, and markedly decreased at 48 and 72 h compared with those of model group(all P<0.05).Conclusions Low molecular heparin could pass to sepsis coagulation-inflammation network adjustment,reduce the expression levels of sTM and sE-selectin in sepsis rats so as to reduce the inflammation of lung tissue damage,and it could obviously alleviate the development of sepsis at a certain extent.