论文部分内容阅读
目的动态监测创伤和感染所致多器官功能障碍综合征(MODS)大鼠血栓调节蛋白(TM)的表达变化,探讨TM在MODS早期器官损伤诊断中的作用。方法实验在三峡大学医学院实验中心完成。将40只健康雄性SD大鼠随机分为正常对照组(8只)、MODS模型组(32只),模型组又分为造模后6、12、24、48 h不同时相,每组8只。采用“二次打击”即眼球失血加腹腔注射脂多糖(LPS)制备MODS模型:大鼠左眼球取血2 ml/100 g,在放血4 h后予无菌腹腔注射LPS 5 mg/kg,正常对照组予以腹腔注射等量的生理盐水,造模完成后在不同的时相点搜集标本。光镜观察肺、肾、肝组织的形态结构变化;采用ELISA法检测MODS不同时相血清中TM的浓度变化;免疫组化法检测TM在MODS肺、肾、肝组织中的表达。结果正常对照组肺、肝、肾组织结构无改变;MODS各组肺、肾及肝组织损伤较重。与正常对照组相比,血清TM的阳性表达6 h组有所增加(P<0.01),12 h达到高峰(P<0.01),随后24～48 h下降,与正常对照组比较均有显著性降低(P<0.01～0.05)。与正常对照组相比,肺、肾及肝组织TM的阳性表达6 h组有所增加,12 h达到高峰(P<0.01),随后24～48 h下降。结论高表达的TM参与了MODS器官损伤的病理过程,可能作为早期组织器官损伤重要的监测指标。
Objective To dynamically monitor the expression of thrombomodulin (TM) in rats with multiple organ dysfunction syndrome (MODS) induced by trauma and infection and to explore the role of TM in the early diagnosis of organ damage in MODS. Methods Experiments were completed at the Experimental Center of Three Gorges University Medical College. Forty healthy male SD rats were randomly divided into normal control group (n = 8) and MODS model group (n = 32). The model group was divided into 6, 12, 24 and 48 h after modeling, with 8 only. MODS model was established by intraperitoneal injection of lipopolysaccharide (LPS) with “second strike” and 2 ml / 100 g of blood from the left eyeball of rats. After 4 h of exsanguination, rats were injected intraperitoneally with LPS 5 mg / kg , The normal control group was injected intraperitoneally with the same amount of saline, and the specimens were collected at different time points after the model establishment. The morphological changes of lung, kidney and liver were observed under light microscope. The concentrations of TM in sera of MODS at different phases were detected by ELISA. The expression of TM in lung, kidney and liver of MODS was detected by immunohistochemistry. Results There was no change in the lung, liver and kidney tissues in the normal control group. The lung, kidney and liver tissues in the MODS groups were severely damaged. Compared with the normal control group, the positive expression of serum TM increased in 6 h group (P <0.01), peaked at 12 h (P <0.01), then decreased from 24 h to 48 h, which was significantly higher than that in normal control group Decreased (P <0.01 ~ 0.05). Compared with the normal control group, the positive expression of TM in lung, kidney and liver tissue increased at 6 h, reached the peak at 12 h (P <0.01), and then decreased from 24 h to 48 h. Conclusion Highly expressed TM is involved in the pathological process of organ damage in MODS and may be used as an important monitoring indicator of early tissue and organ damage.