中国感染与化疗杂志
中國感染與化療雜誌
중국감염여화료잡지
Chinese Journal of Infection and Chemotherapy
2015年
5期
479-484
,共6页
曾建琼%程青虹%何永来%齐研
曾建瓊%程青虹%何永來%齊研
증건경%정청홍%하영래%제연
脓毒症%目标血糖管理%过氧化物酶体增殖物激活受体α%肉毒碱棕榈酰基转移酶1%大鼠
膿毒癥%目標血糖管理%過氧化物酶體增殖物激活受體α%肉毒堿棕櫚酰基轉移酶1%大鼠
농독증%목표혈당관리%과양화물매체증식물격활수체α%육독감종려선기전이매1%대서
sepsis%glucose control%peroxisome proliferator activated receptor-α%carnitine palmitoyltransferase 1%rat
目的：探讨胰岛素控制不同目标血糖水平对脓毒症大鼠肝脏损伤的影响及相关机制。方法40只SD大鼠随机分为5组：假手术组、脓毒症组和血糖控制水平由低到高的A组、B组、C组，每组各8只。盲肠结扎穿孔术后12 h处死，处死动物后取静脉血检测血清丙氨酸转氨酶（ALT）、天冬氨酸转氨酶（AST）和游离脂肪酸（FFA）水平，免疫组化测定肝组织过氧化物酶体增殖物激活受体α（PPAR‐α）及肉毒碱棕榈酰基转移酶1（CPT‐1）表达水平，光镜观察肝组织病理切片。结果①脓毒症组血清ALT、AST、FFA及肝脏病理评分明显高于假手术组和各血糖控制组（P＜0．05），A组较B、C组明显降低（P＜0．05）， B组低于C组（P＜0．05）；②脓毒症组肝组织CPT‐1及PPAR‐α的表达明显低于各血糖控制组及假手术组，但与C组差异无统计学意义（P＞0．05），A组较B、C组明显增高（P＜0．05），B组高于C组（P＜0．05）。结论血糖控制为4．4～6．1 mmol／L对脓毒症大鼠肝脏损伤保护作用最明显，其机制可能与上调肝脏PPAR‐α及CPT‐1的表达有关。
目的：探討胰島素控製不同目標血糖水平對膿毒癥大鼠肝髒損傷的影響及相關機製。方法40隻SD大鼠隨機分為5組：假手術組、膿毒癥組和血糖控製水平由低到高的A組、B組、C組，每組各8隻。盲腸結扎穿孔術後12 h處死，處死動物後取靜脈血檢測血清丙氨痠轉氨酶（ALT）、天鼕氨痠轉氨酶（AST）和遊離脂肪痠（FFA）水平，免疫組化測定肝組織過氧化物酶體增殖物激活受體α（PPAR‐α）及肉毒堿棕櫚酰基轉移酶1（CPT‐1）錶達水平，光鏡觀察肝組織病理切片。結果①膿毒癥組血清ALT、AST、FFA及肝髒病理評分明顯高于假手術組和各血糖控製組（P＜0．05），A組較B、C組明顯降低（P＜0．05）， B組低于C組（P＜0．05）；②膿毒癥組肝組織CPT‐1及PPAR‐α的錶達明顯低于各血糖控製組及假手術組，但與C組差異無統計學意義（P＞0．05），A組較B、C組明顯增高（P＜0．05），B組高于C組（P＜0．05）。結論血糖控製為4．4～6．1 mmol／L對膿毒癥大鼠肝髒損傷保護作用最明顯，其機製可能與上調肝髒PPAR‐α及CPT‐1的錶達有關。
목적：탐토이도소공제불동목표혈당수평대농독증대서간장손상적영향급상관궤제。방법40지SD대서수궤분위5조：가수술조、농독증조화혈당공제수평유저도고적A조、B조、C조，매조각8지。맹장결찰천공술후12 h처사，처사동물후취정맥혈검측혈청병안산전안매（ALT）、천동안산전안매（AST）화유리지방산（FFA）수평，면역조화측정간조직과양화물매체증식물격활수체α（PPAR‐α）급육독감종려선기전이매1（CPT‐1）표체수평，광경관찰간조직병리절편。결과①농독증조혈청ALT、AST、FFA급간장병리평분명현고우가수술조화각혈당공제조（P＜0．05），A조교B、C조명현강저（P＜0．05）， B조저우C조（P＜0．05）；②농독증조간조직CPT‐1급PPAR‐α적표체명현저우각혈당공제조급가수술조，단여C조차이무통계학의의（P＞0．05），A조교B、C조명현증고（P＜0．05），B조고우C조（P＜0．05）。결론혈당공제위4．4～6．1 mmol／L대농독증대서간장손상보호작용최명현，기궤제가능여상조간장PPAR‐α급CPT‐1적표체유관。
Objective To examine the effect and mechanism of different targets of glucose control on liver damage in rats with sepsis .Methods The rat sepsis model was established by cecal ligation and puncture (CLP) .Forty Sprague‐Dawley rats were randomly divided into five groups (eight rats to each group):sham operation (sham group) ,sepsis (CLP group) ,glycemic control A group (glucose target 4 .6‐6 .1 mmol/L ) ,glycemic control B group (glucose target 6 .2‐8 .3 mmol/L ) and glycemic control C group (glucose target 8 .4‐10 .0 mmol/L) .The animals were sacrificed 12 hours after CLP .Venous blood was sampled for testing alanine transaminase (ALT ) , aspartate transaminase (AST ) and free fatty acid (FFA ) . Peroxisome proliferator activated receptor‐α (PPAR‐α) and liver carnitine palmitoyltransferase 1 (CPT‐1 ) protein were determined by immunohistochemistry .The pathological changes of liver tissue was observed under an optical microscope .Results The levels of ALT ,AST and FFA in venous blood and the pathological tissue injury score in sepsis groups were higher than those in sham group and all glycemic control groups (P<0 .05) .However ,the level of these markers significantly decreased in group A than those in group B or group C (P<0 .05) ,and lower in group B than those in group C (P< 0 .05) .PPARα and liver CPT‐1 expression levels were lower in sepsis group than those in sham group and all glycemic control groups except group C (P>0 .05) .The levels of PPARαand liver CPT‐1 were significantly higher in group A than in group B or group C (P<0 .05) ,and lower in group C than in group B(P<0 .05) .Conclusions The lowest target of glucose control(4 .6‐6 .1 mmol/L)shows better protective effects on liver damage in rats with sepsis ,the mechanism of which may be related to upregulation of PPARα and liver CPT‐1 expression .
