本文選題：干熱環(huán)境 + 創(chuàng)傷失血性休克�。� 參考：《石河子大學(xué)》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(xué)特點(diǎn)及變化,同時(shí)探討細(xì)胞凋亡及炎癥反應(yīng)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(jù)。方法:健康雄性長白仔豬68只,利用隨機(jī)數(shù)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(shù)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(shí)驗(yàn)前均在西北特殊環(huán)境人工實(shí)驗(yàn)艙(由新疆軍區(qū)總醫(yī)院研制)中暴露3小時(shí),溫度設(shè)置為40.5℃±0.5℃,濕度設(shè)置為10%±2%,且將DHS組和DHC組隨機(jī)分為4個(gè)亞組:T0(實(shí)驗(yàn)艙中暴露3小時(shí))、T1(模型成功50min)、T2(模型成功100min)、T3(模型成功150min);NTS組在常溫實(shí)驗(yàn)艙中暴露3小時(shí),溫度及濕度分別設(shè)置:25℃±1℃,35%±5%,同樣將NTS組分為4個(gè)亞組,具體時(shí)間點(diǎn)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(xué)檢查和JNK-2,Caspase-3及Cyto C的表達(dá)情況。結(jié)果:(1)與NTS組相比,DHS組在干熱環(huán)境暴露3小時(shí)后,血尿素氮和肌酐水平增高,但無統(tǒng)計(jì)學(xué)差異(P0.05),隨著時(shí)間延長,腎損傷指標(biāo)升高越來越明顯。與DHC組相比,DHS組指標(biāo)在T2時(shí)間點(diǎn)表現(xiàn)出差異(P0.05);(2)與NTS組相比,DHS組在干熱環(huán)境暴露3小時(shí)后,尿NGAL略有增高,但無統(tǒng)計(jì)學(xué)差異(P0.05),成模50min時(shí)才有統(tǒng)計(jì)學(xué)差異(P0.05)。與DHC組相比,DHS組在T1開始均有統(tǒng)計(jì)學(xué)差異(P0.05)。(3)隨著干熱環(huán)境暴露時(shí)間的延長,腎臟光鏡下逐漸出現(xiàn)Bowman腔擴(kuò)張,腔內(nèi)有變性脫落壞死細(xì)胞,腎小管上皮細(xì)胞水腫等;而干熱合并創(chuàng)傷失血性休克則表現(xiàn)為腎小球毛細(xì)血管充血、擴(kuò)張,腎小管上皮細(xì)胞水腫,Bowman腔內(nèi)有變性脫落上皮細(xì)胞,遠(yuǎn)曲小管上皮細(xì)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(shí)后開始升高且有統(tǒng)計(jì)學(xué)差異(P0.05),與DHC組相比,DHS組的表達(dá)在T1時(shí)間點(diǎn)才表現(xiàn)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(shí)后,JNK-2表達(dá)開始增高且具有統(tǒng)計(jì)學(xué)差異(P0.01),而Cytochrome C和Caspase-3的表達(dá)無統(tǒng)計(jì)學(xué)差異(P0.05),T3時(shí)間點(diǎn)后均可出現(xiàn)統(tǒng)計(jì)學(xué)差異(P0.01)。與DHC組相比,DHS組在干熱環(huán)境暴露3小時(shí)后無差異,而在T3時(shí)間點(diǎn),DHS組各指標(biāo)表達(dá)量均顯著增高且具有統(tǒng)計(jì)學(xué)差異(P0.01)。(6)與NTS組相比,DHS組在干熱環(huán)境暴露后,細(xì)胞凋亡情況無統(tǒng)計(jì)學(xué)差異(P0.05),到T1時(shí)間點(diǎn),細(xì)胞凋亡率明顯增高,且具有統(tǒng)計(jì)學(xué)差異(P0.01);與DHC組相比,在T1時(shí)間點(diǎn)細(xì)胞凋亡率也顯著增高,且具有統(tǒng)計(jì)學(xué)差異(P0.01)。結(jié)論:當(dāng)干熱環(huán)境合并創(chuàng)傷失血性休克時(shí),干熱環(huán)境和創(chuàng)傷失血性休克共同驅(qū)動炎癥因子的表達(dá)和線粒體引起的細(xì)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(jìn)一步惡化,導(dǎo)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