本文選題：膿毒癥休克 + 腎損傷��； 參考：《川北醫(yī)學(xué)院》2017年碩士論文

【摘要】：目的:通過耳緣靜脈注射脂多糖(lipopolysaccharide,LPS)建立新西蘭兔膿毒癥休克模型,以靜脈持續(xù)泵注極化液干預(yù),研究極化液對(duì)膿毒癥休克兔腎臟損傷的影響。方法:30只新西蘭大白兔隨機(jī)分成三組。脂多糖組(LPS組,n=10)和極化液治療組(GIK組,n=10):經(jīng)耳緣靜脈注射脂多糖0.5mg/kg,正常對(duì)照組(N組,n=10):耳緣靜脈注射等劑量生理鹽水。造模成功后,GIK組經(jīng)耳緣靜脈持續(xù)泵注極化液(5ml/kg/h),N組和LPS組以相同的速度泵注復(fù)方氯化鈉溶液。連續(xù)監(jiān)測(cè)三組兔的生命體征;分別在造模前、造模成功后以及治療3、6小時(shí)后抽取血液標(biāo)本檢測(cè)血糖、乳酸、血鉀、Cys-C水平;治療6小時(shí)后處死動(dòng)物,檢測(cè)腎臟TNF-ɑ、MDA、Caspase-3水平,HE染色觀察病理變化情況,電鏡觀察線粒體損傷情況。結(jié)果:1.生命體征改變:與N組相比,LPS組兔表現(xiàn)為呼吸加快、平均動(dòng)脈壓降低、體溫升高等(P0.05),GIK組兔以上表現(xiàn)相較LPS組有所減輕。2.血?dú)夥治龅淖兓?與N組相比,LPS組血糖升高、乳酸明顯升高、PCO2降低、血鉀升高(P0.05),GIK組與LPS組相比乳酸、血鉀的水平降低(P0.05)。3.腎臟損傷指標(biāo)的變化:與N組相比,LPS組與GIK組TNF-ɑ、Cys-C、MDA水平明顯升高(P0.05),LPS組較GIK組更高(P0.05);HE染色顯示GIK干預(yù)組腎臟病理損傷輕于LPS組,N組損傷輕于GIK組。4.細(xì)胞凋亡指標(biāo)結(jié)果:與LPS組相比,GIK組Caspase-3的表達(dá)下調(diào)(P0.05)。與N組相比,GIK組Caspase-3的表達(dá)上調(diào)(P0.05)。5.電鏡結(jié)果:與N組相比,LPS組腎小管上皮細(xì)胞內(nèi)線粒體腫脹明顯,而GIK組線粒體結(jié)構(gòu)清晰可見,無膜斷裂,腫脹較LPS組輕。結(jié)論:GIK能通過減輕線粒體損傷、減少腎組織細(xì)胞凋亡,對(duì)LPS誘導(dǎo)的膿毒癥休克性兔腎損傷具有保護(hù)作用。
[Abstract]:Aim: to establish a septic shock model in New Zealand rabbits by intravenous injection of lipopolysaccharide and lipopolysaccharide (LPSs) at the ear edge, and to study the effect of pollination solution on renal injury in rabbits with septic shock. Methods 30 New Zealand white rabbits were randomly divided into three groups. Lipopolysaccharide (LPS) group (LPS-10) and Polarizate treatment group (GIK group): LPS-0.5 mg / kg was injected via ear margin, and normal control group (n group) was injected intravenously with normal saline. After the establishment of the model, the GIK group was injected with 5 ml / kg 路kg ~ (-1) 路h ~ (-1) of poling solution through the auricular vein at the same speed as the LPS group. The vital signs of the three groups of rabbits were continuously monitored, blood samples were collected before, after successful modeling and 3 hours after treatment for blood glucose, lactic acid, blood potassium and Cys-C levels, and the animals were killed after 6 hours of treatment. The level of Caspase-3 in renal TNF- MDA-Caspase-3 was detected by HE staining and mitochondrial damage was observed by electron microscope. The result is 1: 1. The changes of vital signs: compared with group N, lipopolysaccharide group showed faster respiration, lower mean arterial pressure and elevated body temperature, etc. The above manifestations of P0.05GIK group were lighter than those of LPS group. 2. The changes of blood gas analysis: compared with the N group, the blood glucose increased, lactic acid increased significantly and PCO _ 2 decreased in the LPS group, and the level of blood potassium in the GIK group was significantly lower than that in the LPS group, compared with that in the LPS group. The changes of renal injury index: compared with N group, the level of TNF-Cys-Cn MDA in LPS group and GIK group was significantly higher than that in GIK group. The pathological damage of kidney in GIK intervention group was lighter than that in LPS group and GIK group. 4. Results of apoptosis: compared with LPS group, the expression of Caspase-3 in GIK group was down-regulated (P 0.05). Compared with N group, the expression of Caspase-3 was up-regulated in GIK group. The results of electron microscope showed that the mitochondria swelling of tubular epithelial cells in lipopolysaccharide group was more obvious than that in N group, while the mitochondrial structure in GIK group was clearly visible, and there was no rupture of membrane, and the swelling was lighter than that in LPS group. ConclusionGIK can attenuate mitochondria injury and decrease apoptosis of renal tissue, and it has protective effect on septic shock injury induced by LPS in rabbits.
【學(xué)位授予單位】：川北醫(yī)學(xué)院
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2017
【分類號(hào)】：R459.7

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