本文選題：胰島素 + 膿毒癥　； 參考：《廣東醫(yī)學》2015年24期

【摘要】：目的觀察小劑量胰島素對膿毒癥急性肺損傷(ALI)大鼠肺組織血紅素加氧酶-1(HO-1)表達的影響,探討胰島素的肺保護作用。方法 30只雄性SD大鼠隨機分為假手術組、膿毒癥組、胰島素治療組3組,每組10只。膿毒癥組和胰島素治療組采用盲腸結扎穿孔法建立膿毒癥模型,假手術組開腹后未行盲腸結扎穿孔即關腹;胰島素治療組造模后即予皮下注射胰島素0.5 IU/kg,假手術組和膿毒癥組皮下注射等量生理鹽水。各組于建模后12 h處死,分別測定血氧分壓(PaO_2)、肺濕干質量比、超氧化物歧化酶(SOD)、總抗氧化能力(T-AOC)、肺組織NF-κB/p65含量及HO-1表達量、支氣管肺泡灌洗液(BALF)中性粒細胞計數(shù)及髓過氧化物酶(MPO)活性,并在光鏡下觀察肺組織病理表現(xiàn)。結果胰島素治療組、膿毒癥組PaO_2、SOD、T-AOC均明顯低于假手術組(P0.05),而胰島素治療組較膿毒癥組明顯升高(P0.05);胰島素治療組、膿毒癥組肺濕干質量比明顯大于假手術組(P0.05),而胰島素治療組較膿毒癥組明顯降低(P0.05)。胰島素治療組、膿毒癥組BALF中性粒細胞計數(shù)、MPO活性及肺組織NF-κB/p65含量均明顯高于假手術組(P0.05),而胰島素治療組較膿毒癥組明顯降低(P0.05)。胰島素治療組、膿毒癥組肺組織HO-1表達量均明顯高于假手術組(P0.05),且胰島素治療組較膿毒癥組明顯升高(P0.05)。膿毒癥組肺組織病理學損傷程度高于假手術組,而胰島素治療組肺組織炎性病變較膿毒癥組明顯減輕。結論小劑量胰島素可能通過抑制NF-κB活化上調HO-1的表達對膿毒癥ALI大鼠發(fā)揮肺保護作用。
[Abstract]:Objective to observe the effect of low dose insulin on the expression of heme oxygenase-1 (HO-1) in lung tissue of rats with acute lung injury of sepsis and to explore the protective effect of insulin on lung. Methods Thirty male Sprague-Dawley rats were randomly divided into three groups: sham operation group, sepsis group and insulin treatment group. Sepsis model was established by cecal ligation and perforation in sepsis group and insulin treatment group. Insulin treatment group was treated with insulin 0.5 IUP / kg, sham operation group and sepsis group were injected with the same amount of normal saline subcutaneously. The rats were killed at 12 h after modeling. The blood oxygen partial pressure (Pao), lung wet / dry weight ratio, superoxide dismutase (SOD), total antioxidant capacity (T- AOC), the content of NF- 魏 B/p65 and the expression of HO-1 in lung tissue were measured. BALF neutrophil count and myeloperoxidase (MPO) activity in bronchoalveolar lavage fluid (BALF) were observed under light microscope. Results in the insulin treatment group and sepsis group, the P0.05 T-AOC of the Pao _ 2 and SODX were significantly lower than that of the sham operation group, while the insulin treatment group was significantly higher than that of the septic group, and the insulin treatment group was significantly higher than that of the septic group, and the insulin treatment group was significantly higher than that of the septic group. The ratio of wet and dry lung weight in sepsis group was significantly higher than that in sham operation group, while that in insulin treatment group was significantly lower than that in septic group. The BALF neutrophil count and NF- 魏 B/p65 content in insulin treatment group and sepsis group were significantly higher than those in sham operation group (P 0.05), while insulin treatment group was significantly lower than that in sepsis group. The expression of HO-1 in lung tissue of insulin treatment group and sepsis group was significantly higher than that of sham operation group (P 0.05), and that of insulin treatment group was significantly higher than that of sepsis group. The degree of lung histopathological injury in sepsis group was higher than that in sham operation group, while the inflammatory lesion of lung tissue in insulin treatment group was significantly less than that in septic group. Conclusion low dose insulin may play a protective role in the lung of septic ALI rats by inhibiting the activation of NF- 魏 B and up-regulating the expression of HO-1.
【作者單位】： 廣東省深圳市第三人民醫(yī)院急診科;南華大學附屬第一醫(yī)院急診教研室;
【基金】：湖南省2011年第四批省級科技計劃(應用基礎研究、科技專項)項目(編號:2011FJ3170)
【分類號】：R459.7;R563

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