發(fā)布時間：2018-06-01 17:15

  本文選題：干熱環(huán)境 + 創(chuàng)傷失血性休克　； 參考：《石河子大學》2017年碩士論文

【摘要】：目的:本課題通過建立沙漠干熱環(huán)境創(chuàng)傷失血性休克豬模型,研究在干熱環(huán)境合并創(chuàng)傷失血性休克條件下腎損傷的病理生理學特點及變化,同時探討細胞凋亡及炎癥反應對干熱環(huán)境創(chuàng)傷失血性休克豬腎損傷的影響,為臨床救治提供理論依據。方法:健康雄性長白仔豬68只,利用隨機數字表將動物分成3組:干熱創(chuàng)傷失血性休克組(DHS,n=24),干熱創(chuàng)傷失血性休克假手術組(DHC,n=20)和常溫創(chuàng)傷失血性休克組(NTS,n=24)。DHS組和DHC組實驗前均在西北特殊環(huán)境人工實驗艙(由新疆軍區(qū)總醫(yī)院研制)中暴露3小時,溫度設置為40.5℃±0.5℃,濕度設置為10%±2%,且將DHS組和DHC組隨機分為4個亞組:T0(實驗艙中暴露3小時)、T1(模型成功50min)、T2(模型成功100min)、T3(模型成功150min);NTS組在常溫實驗艙中暴露3小時,溫度及濕度分別設置:25℃±1℃,35%±5%,同樣將NTS組分為4個亞組,具體時間點與DHS組和DHC組一致。建立創(chuàng)傷失血性休克模型,取血液檢測血尿素氮和肌酐,取尿液檢測NGAL,收集腎組織行形態(tài)學檢查和JNK-2,Caspase-3及Cyto C的表達情況。結果:(1)與NTS組相比,DHS組在干熱環(huán)境暴露3小時后,血尿素氮和肌酐水平增高,但無統(tǒng)計學差異(P0.05),隨著時間延長,腎損傷指標升高越來越明顯。與DHC組相比,DHS組指標在T2時間點表現出差異(P0.05);(2)與NTS組相比,DHS組在干熱環(huán)境暴露3小時后,尿NGAL略有增高,但無統(tǒng)計學差異(P0.05),成模50min時才有統(tǒng)計學差異(P0.05)。與DHC組相比,DHS組在T1開始均有統(tǒng)計學差異(P0.05)。(3)隨著干熱環(huán)境暴露時間的延長,腎臟光鏡下逐漸出現Bowman腔擴張,腔內有變性脫落壞死細胞,腎小管上皮細胞水腫等;而干熱合并創(chuàng)傷失血性休克則表現為腎小球毛細血管充血、擴張,腎小管上皮細胞水腫,Bowman腔內有變性脫落上皮細胞,遠曲小管上皮細胞脫落。(4)與NTS組相比,DHS組的IL-1β、IL-6、IL-10和TNF-α在干熱環(huán)境中暴露3小時后開始升高且有統(tǒng)計學差異(P0.05),與DHC組相比,DHS組的表達在T1時間點才表現出來差異(P0.05)。(5)與NTS組相比,DHS組在干熱環(huán)境中暴露3小時后,JNK-2表達開始增高且具有統(tǒng)計學差異(P0.01),而Cytochrome C和Caspase-3的表達無統(tǒng)計學差異(P0.05),T3時間點后均可出現統(tǒng)計學差異(P0.01)。與DHC組相比,DHS組在干熱環(huán)境暴露3小時后無差異,而在T3時間點,DHS組各指標表達量均顯著增高且具有統(tǒng)計學差異(P0.01)。(6)與NTS組相比,DHS組在干熱環(huán)境暴露后,細胞凋亡情況無統(tǒng)計學差異(P0.05),到T1時間點,細胞凋亡率明顯增高,且具有統(tǒng)計學差異(P0.01);與DHC組相比,在T1時間點細胞凋亡率也顯著增高,且具有統(tǒng)計學差異(P0.01)。結論:當干熱環(huán)境合并創(chuàng)傷失血性休克時,干熱環(huán)境和創(chuàng)傷失血性休克共同驅動炎癥因子的表達和線粒體引起的細胞凋亡在腎損傷中具有重要作用。它可以加速腎小球及腎小管的損傷,使腎功能進一步惡化,導致急性腎損傷的發(fā)生。
[Abstract]:Objective: to study the pathophysiological characteristics and changes of renal injury in dry heat environment combined with traumatic hemorrhagic shock by establishing a pig model of hemorrhagic shock in desert dry heat environment. At the same time, the effects of apoptosis and inflammatory reaction on renal injury in pigs with hemorrhagic shock after dry heat environment trauma were studied, which provided a theoretical basis for clinical treatment. Methods: 68 healthy male Landrace piglets were used. Animals were randomly divided into three groups: dry heat trauma hemorrhagic shock group, dry heat trauma hemorrhagic shock sham-operation group, and normothermic trauma hemorrhagic shock group. The cabin inspection (developed by the General Hospital of the Xinjiang military region) was exposed for 3 hours, The temperature was set to 40.5 鈩，

本文編號：1965013