本文選題：失血性休克　切入點(diǎn)：再灌注　出處：《新疆醫(yī)科大學(xué)》2008年碩士論文

【摘要】： 目的觀察新西蘭大白兔失血性休克再灌注后小動(dòng)脈的形態(tài)學(xué)改變,探索α-SMA、ICAM-1在再灌注后不同時(shí)點(diǎn)的表達(dá)與小動(dòng)脈的形態(tài)改變的關(guān)系。方法將35只新西蘭大白兔分為(1)對照組;(2)急性失血性休克25分鐘組;(3)失血休克再灌注3/4小時(shí)組;(4)失血休克再灌注1小時(shí)組;(5)失血休克再灌注2小時(shí)組;(6)失血休克再灌注3小時(shí)組;(7)失血休克再灌注4小時(shí)組,依次分為A組、B組、C組、D組、E組、F組、G組,各組均為5只;失血休克再灌注各組在急性失血性休克25分鐘后由靜脈緩慢回輸所抽動(dòng)脈血及等量生理鹽水,取心、腦、腎、空腸及下肢小動(dòng)脈,用光鏡和透射電鏡觀察小動(dòng)脈內(nèi)皮細(xì)胞和平滑肌細(xì)胞的形態(tài),同時(shí)用免疫組織化學(xué)的方法顯示α-SMA、ICAM-1在小動(dòng)脈內(nèi)皮細(xì)胞和平滑肌細(xì)胞中的表達(dá)。結(jié)果1.光鏡下和電鏡下見B組的小動(dòng)脈內(nèi)皮細(xì)胞個(gè)別脫落,平滑肌細(xì)胞輕微水腫。再灌注后內(nèi)皮細(xì)胞壞死脫落、血管平滑肌細(xì)胞水腫明顯,平滑肌細(xì)胞向內(nèi)膜遷移,再灌注1小時(shí)損傷最顯著。腦皮質(zhì)與其他組織小動(dòng)脈相比較,在缺血再灌注后不同時(shí)點(diǎn)的損傷較輕。再灌注3小時(shí)后逐漸恢復(fù)。2.A組α-SMA各組織均適度表達(dá),B組α-SMA表達(dá)降低,再灌注1小時(shí)達(dá)到最低,再灌注3小時(shí)表達(dá)增加。D組、E組、F組、G組和A組比較,差異均有統(tǒng)計(jì)學(xué)意義(P0.05)。3.A組ICAM-1有少量表達(dá),B組ICAM-1表達(dá)首先增加,再灌注后4小時(shí)達(dá)到高峰。D組、E組、F組、G組和A組比較,差異均有統(tǒng)計(jì)學(xué)意義(P0.05)。結(jié)論1.新西蘭大白兔失血性休克再灌注小動(dòng)脈內(nèi)皮細(xì)胞和平滑肌細(xì)胞損傷各時(shí)間點(diǎn)表現(xiàn)不同。2.α-SMA的表達(dá)在各實(shí)驗(yàn)組與A組比較中有統(tǒng)計(jì)學(xué)差異(P0.05),提示α-SMA與血管平滑肌細(xì)胞的舒縮狀態(tài)有密切的關(guān)系,平滑肌細(xì)胞在再灌注各時(shí)點(diǎn)處于不同的收縮狀態(tài);ICAM-1的表達(dá)在各實(shí)驗(yàn)組與A組比較中有統(tǒng)計(jì)學(xué)差異(P0.05),提示缺血再灌注具有炎癥反應(yīng)的特征是由于ICAM-1在內(nèi)皮細(xì)胞表達(dá)升高造成的,再灌注炎癥反應(yīng)致使內(nèi)皮細(xì)胞腫脹,小動(dòng)脈內(nèi)徑縮小,導(dǎo)致血流灌注量減少。
[Abstract]:Objective to observe the morphological changes of arterioles after hemorrhagic shock reperfusion in New Zealand white rabbits and to explore the relationship between the expression of 偽 -SMA-ICAM-1 at different time points after reperfusion and the morphological changes of arterioles.3 hours after reperfusion, 7) hemorrhagic shock and 4 hours reperfusion group,The morphology of vascular endothelial cells and smooth muscle cells in jejunum and lower extremity arterioles were observed by light microscope and transmission electron microscope, and the expression of 偽 -SMA-ICAM-1 in endothelial cells and smooth muscle cells of arterioles was detected by immunohistochemical method.Result 1.Under the light microscope and electron microscope, the endothelial cells of arterioles in group B were isolated, and the smooth muscle cells were slightly edema.After reperfusion, endothelial cells necrotic and shedding, vascular smooth muscle cells edema, smooth muscle cells migrated to the intima, the most significant injury was 1 hour after reperfusion.The cerebral cortex was slightly damaged at different time points after ischemia reperfusion compared with other tissue arterioles.After 3 hours of reperfusion, the expression of 偽 -SMA in group A decreased gradually, and the expression of 偽 -SMA in group B reached the lowest level at 1 hour after reperfusion. The expression of 偽 -SMA in group D increased at 3 hours after reperfusion, and the expression of 偽 -SMA in group A was higher than that in group A, and the expression of 偽 -SMA in group A was higher than that in group A.There were significant differences in the expression of ICAM-1 in group B and group B at first, and reached the peak at 4 hours after reperfusion in group E, group E, group E, group F, group G and group A, and the difference was statistically significant (P 0.05).Conclusion 1.The expression of 偽 -SMA was significantly different in each experimental group compared with group A, suggesting that 偽 -SMA and vascular smooth muscle cells (VSMCs) were significantly different in each experimental group compared with group A, which indicated that the expression of 偽 -SMA and vascular smooth muscle cells (VSMCs) in rabbits with hemorrhagic shock and reperfusion was different at different time points.There is a close relationship between the state of relaxation and contraction,The expression of ICAM-1 in smooth muscle cells at different time points of reperfusion was significantly different between the experimental group and group A, suggesting that the inflammatory response of ischemia reperfusion was due to the increased expression of ICAM-1 in endothelial cells.The inflammatory reaction of reperfusion resulted in the swelling of endothelial cells and the reduction of arteriole diameter, which resulted in a decrease in blood perfusion.
【學(xué)位授予單位】：新疆醫(yī)科大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2008
【分類號(hào)】：R459.7;R361.2

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本文編號(hào)：1714995