CAJ | 학술논문

目的：观察腹主动脉结扎术＋腹腔LPS注射复制脓毒症心肾综合征模型大鼠心脏及肾脏组织病理改变及心肾组织TNF-α表达的变化。方法将40只Wistar大鼠随机分为4组：假手术组（A组），腹主动脉阻断（AAC）组（B组），内毒素（LPS）组（C组），腹主动脉阻断＋内毒素组（ AAC＋LPS）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心脏及肾脏行HE染色观察心肾组织病理损害，免疫组化检测心肾组织TNF-α表达的变化。结果 D组死亡率最高。心脏组织HE染色显示：A组未见明显的病理改变；B组心肌组织紊乱，少数心肌变性、溶解，部分心肌纤维断裂，毛细血管充血、扩张，肌间隙内可见红细胞漏出、炎性细胞浸润，损伤程度较C组略重；C组心肌组织紊乱，心肌细胞略肿胀，肌间隙内可见红细胞漏出、炎性细胞浸润；D组心肌细胞明显肿胀，肌间隙增宽，小血管充血明显，内有大量红细胞聚集，肌间隙内可见大量红细胞漏出，纤维变性、坏死，肌间隙炎性细胞明显增多聚集、贴壁，甚至出现结构模糊的溶断现象。心脏TNF-α表达量为A、C、B、D组依次递增， B、C组之间比较无显著差异，余各组之间均有显著性差异（ P均＜0.05）。肾脏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。肾脏TNF-α表达平均总面积以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组比较无显著性差异。结论本研究成功复制出了脓毒症大鼠心肾综合征模型；并证实了大鼠在腹主动脉阻断合并脓毒症时存在明显的心肾形态学改变和心肌及肾组织损伤；TNF-α作为一种至关重要的前炎性因子，在腹主动脉阻断合并脓毒症时急性心肾组织损伤中发挥了重要作用。目的：觀察腹主動脈結扎術＋腹腔LPS註射複製膿毒癥心腎綜閤徵模型大鼠心髒及腎髒組織病理改變及心腎組織TNF-α錶達的變化。方法將40隻Wistar大鼠隨機分為4組：假手術組（A組），腹主動脈阻斷（AAC）組（B組），內毒素（LPS）組（C組），腹主動脈阻斷＋內毒素組（ AAC＋LPS）組（ D組）。所有動物于再灌註後8 h處死，4％多聚甲醛灌註固定後取心髒及腎髒行HE染色觀察心腎組織病理損害，免疫組化檢測心腎組織TNF-α錶達的變化。結果 D組死亡率最高。心髒組織HE染色顯示：A組未見明顯的病理改變；B組心肌組織紊亂，少數心肌變性、溶解，部分心肌纖維斷裂，毛細血管充血、擴張，肌間隙內可見紅細胞漏齣、炎性細胞浸潤，損傷程度較C組略重；C組心肌組織紊亂，心肌細胞略腫脹，肌間隙內可見紅細胞漏齣、炎性細胞浸潤；D組心肌細胞明顯腫脹，肌間隙增寬，小血管充血明顯，內有大量紅細胞聚集，肌間隙內可見大量紅細胞漏齣，纖維變性、壞死，肌間隙炎性細胞明顯增多聚集、貼壁，甚至齣現結構模糊的溶斷現象。心髒TNF-α錶達量為A、C、B、D組依次遞增， B、C組之間比較無顯著差異，餘各組之間均有顯著性差異（ P均＜0.05）。腎髒HE染色顯示：A組無明顯病理改變；B組可見輕度損傷；C組較B組病理改變嚴重；D組最為嚴重。腎髒TNF-α錶達平均總麵積以A、B、C、D組依次遞增；與A組比較，B、C、D組均顯著增加（P均＜0．05），但B組與C組比較無顯著性差異。結論本研究成功複製齣瞭膿毒癥大鼠心腎綜閤徵模型；併證實瞭大鼠在腹主動脈阻斷閤併膿毒癥時存在明顯的心腎形態學改變和心肌及腎組織損傷；TNF-α作為一種至關重要的前炎性因子，在腹主動脈阻斷閤併膿毒癥時急性心腎組織損傷中髮揮瞭重要作用。
목적：관찰복주동맥결찰술＋복강LPS주사복제농독증심신종합정모형대서심장급신장조직병리개변급심신조직TNF-α표체적변화。방법장40지Wistar대서수궤분위4조：가수술조（A조），복주동맥조단（AAC）조（B조），내독소（LPS）조（C조），복주동맥조단＋내독소조（ AAC＋LPS）조（ D조）。소유동물우재관주후8 h처사，4％다취갑철관주고정후취심장급신장행HE염색관찰심신조직병리손해，면역조화검측심신조직TNF-α표체적변화。결과 D조사망솔최고。심장조직HE염색현시：A조미견명현적병리개변；B조심기조직문란，소수심기변성、용해，부분심기섬유단렬，모세혈관충혈、확장，기간극내가견홍세포루출、염성세포침윤，손상정도교C조략중；C조심기조직문란，심기세포략종창，기간극내가견홍세포루출、염성세포침윤；D조심기세포명현종창，기간극증관，소혈관충혈명현，내유대량홍세포취집，기간극내가견대량홍세포루출，섬유변성、배사，기간극염성세포명현증다취집、첩벽，심지출현결구모호적용단현상。심장TNF-α표체량위A、C、B、D조의차체증， B、C조지간비교무현저차이，여각조지간균유현저성차이（ P균＜0.05）。신장HE염색현시：A조무명현병리개변；B조가견경도손상；C조교B조병리개변엄중；D조최위엄중。신장TNF-α표체평균총면적이A、B、C、D조의차체증；여A조비교，B、C、D조균현저증가（P균＜0．05），단B조여C조비교무현저성차이。결론본연구성공복제출료농독증대서심신종합정모형；병증실료대서재복주동맥조단합병농독증시존재명현적심신형태학개변화심기급신조직손상；TNF-α작위일충지관중요적전염성인자，재복주동맥조단합병농독증시급성심신조직손상중발휘료중요작용。
Objective It is to observe the pathology changes and the expression of TNF -αof heart and kidney in rats with cardiorenal syndrome of sepsis model by combing abdominal aortic clamping ( AAC) with intraperitoneal injection of LPS . Methods 40 Wistar rats were randomly divided into four groups:sham operated group (Group A), AAC group (Group B), intraperitoneal injection of LPS group (Group C),AAC+LPS group (Group D).All animal were killed after 8 hours’ reper-fusion, the cardiac and renal were get out after perfusion fixation with 4%paraformaldehyde, the pathological damage of heart and kidney tissue were observed by HE staining , and the expression of TNF-a in heart and renal tissue were detected by im -munohistochemical method .Results The mortality rate of Group D was the highest .The HE staining of Group A of heart tissue was not obvious .Group B was more serious than Group C .And Group D was most serious .The expression of TNF-αof heart was increased from A , C, B, D.Except between Group B and Group , there were significant differences among all groups . The HE staining of Group A of renal tissue was not obvious .Group B showed mild injury .The pathological change of Group C was more serious than Group B .Group D was most serious .The expression of TNF-αof kidney was increased from A , B, C, D (all P<0.05), but there was no significant difference between Group B and Group C .Conclusion The research make cardiorenal syndrome of sepsis successful .The morphological changes and tissue damage of cardiac and renal were obvious in rats with abdominal aorta clamping and sepsis .The function of inflammatory factor TNF-αis very important in this model .