發(fā)布時間：2018-06-16 09:12

  本文選題：膿毒癥 + 腸粘膜　； 參考：《第二軍醫(yī)大學(xué)》2013年碩士論文

【摘要】：目的：通過觀察膿毒癥大鼠小腸粘膜、腸壁血流量和腸組織氧合的改變，探討大黃保護(hù)腸粘膜微循環(huán)的可能性及作用機(jī)制。方法：選用健康雄性SD大鼠56只，體重220-250g，隨機(jī)分為對照組、假手術(shù)組、膿毒癥組和大黃治療組，采用盲腸結(jié)扎穿孔（CLP）膿毒癥模型，大黃治療組在CLP造模前給予大黃（50mg/kg）灌胃，2次/日×2日，其他組給予灌胃等量生理鹽水。模型制備后24小時用moorFLPI散斑血流實時成像系統(tǒng)檢測小腸粘膜、腸壁的血流量；用ELISA方法測定腸組織勻漿上清液乳酸和丙酮酸濃度并計算乳酸/丙酮酸的比值；用明膠墨汁灌注+HE染色顯示腸粘膜毛細(xì)血管，并計算微血管面積（MVA）；免疫組化檢測腸粘膜毛細(xì)血管CD31的表達(dá)并計算微血管密度（MVD）。結(jié)果：（1）與膿毒癥組（2020.3±353.4）比較，正常組（2799.4±370.6，p0.01）、假手術(shù)組（2514.2±484.9，p0.01）、大黃治療組（2653.0±284.0，p0.01）大鼠腸壁血流量較高（血流單位pu）；（2）同樣，與膿毒癥組腸粘膜血流量（1662.6±462.0）比較，正常組（2548.2±336.5，p0.05）、假手術(shù)組（2514.0±565.1，p0.05）、大黃治療組（2383.2±834.9，，p0.05）血流量較高（血流單位pu）。（3）與正常組（0.52±0.05，p0.01）、假手術(shù)組（0.43±0.04，p0.01）和大黃治療組（0.50±0.02，p0.01）相比，CLP膿毒癥模型組（0.64±0.03）小腸組織乳酸/丙酮酸比值增高。（4）與膿毒癥組大鼠（3.68±1.13）比較，正常組（6.26±0.69，p0.01）、假手術(shù)組（6.04±0.37，p0.01）、膿毒癥大黃治療組（6.73±1.52，p0.01）大鼠的單位面積內(nèi)腸粘膜血管面積明顯較高。（5）與膿毒癥組大鼠（41.08±5.90）比較，正常組（59.42±5.43，p0.01）、假手術(shù)組（55.08±5.80，p0.01）、膿毒癥大黃治療組（56.87±6.36，p0.01）大鼠腸粘膜單位面積內(nèi)毛細(xì)血管計數(shù)明顯較高。結(jié)論：大黃可以擴(kuò)張腸粘膜毛細(xì)血管、減少血栓形成、保護(hù)腸粘膜毛細(xì)血管內(nèi)皮細(xì)胞，增加腸粘膜功能毛細(xì)血管數(shù)量，從而改善膿毒癥狀態(tài)腸粘膜的血供和氧供。
[Abstract]:Aim: to investigate the possibility and mechanism of rhubarb in protecting intestinal mucosal microcirculation by observing the changes of intestinal mucosal and intestinal wall blood flow and intestinal tissue oxygenation in septic rats. Methods: Fifty-six male Sprague-Dawley rats, weighing 220 to 250 g, were randomly divided into three groups: control group, sham operation group, sepsis group and rhubarb treatment group. The model of sepsis was induced by cecal ligation and perforation (CLP). The rhubarb treatment group was given 50 mg / kg rhubarb twice a day 脳 2 days before CLP. The other groups were given the same amount of normal saline. 24 hours after the model was made, the blood flow of intestinal mucosa and intestinal wall was measured by moorFLPI speckle flow real time imaging system, the concentration of lactate and pyruvate in supernatant of intestinal homogenate was measured by Elisa and the ratio of lactate to pyruvate was calculated. Gelatin ink perfusion HE staining was used to show the intestinal mucosal capillaries, and the microvessel area was calculated. The expression of CD31 in intestinal mucosal capillaries was detected by immunohistochemistry and the microvessel density was calculated. Results compared with sepsis group (2020.3 鹵353.4), the intestinal wall blood flow in normal group (2799.4 鹵370.6), sham operation group (2514.2 鹵484.9), rhubarb treatment group (2653.0 鹵284.0 p0.01) was higher than that in septic group (blood flow unit putaman2), which was also higher than that in septic group (1662.6 鹵462.0). The blood flow was higher in normal group (2548.2 鹵336.5), sham operation group (2514.0 鹵565.1), rhubarb treatment group (2383.2 鹵834.9p0.05) (blood flow unit pu.f.3) and normal group (0.52 鹵0.05p 0.01, sham operation group 0.43 鹵0.04p0.01) and rhubarb treatment group (0.50 鹵0.02p0.01) compared with CLP sepsis model group (0.64 鹵0.03) and the ratio of small intestinal tissue to pyruvate increased by 0.64 鹵0.03). The comparison between the rats of toxic group (3.68 鹵1.13) and the control group (3. 68 鹵1. 13), The intestinal mucosal vascular area in the normal group (6.26 鹵0.69p 0.01g), the sham-operated group (6.04 鹵0.37p0.01g) and the septic rhubarb treatment group (6.73 鹵1.52p0.01) was significantly higher than that in the septic group (41.08 鹵5.90), and that in the control group was significantly higher than that in the sepsis group (41.08 鹵5.90). In the normal group (59.42 鹵5.43), the sham operation group (55.08 鹵5.80) and the septic rhubarb treatment group (56.87 鹵6.36), the capillary count in the intestinal mucosal unit area was significantly higher than that in the sham operation group (55.08 鹵5.80) and the septic rhubarb treatment group (56.87 鹵6.36). Conclusion: rhubarb can dilate intestinal mucosal capillaries, reduce thrombosis, protect intestinal mucosal capillary endothelial cells, increase the number of intestinal mucosal functional capillaries, and improve blood supply and oxygen supply of intestinal mucosa in septic state.
【學(xué)位授予單位】：第二軍醫(yī)大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2013
【分類號】：R459.7

【參考文獻(xiàn)】

相關(guān)期刊論文 前10條

1 童建斌;曾樂平;陳旦;周瑾;黃菊芳;羅學(xué)港;;明膠墨汁灌注展示大鼠視網(wǎng)膜血管的方法[J];第三軍醫(yī)大學(xué)學(xué)報;2007年21期

2 劉紹澤;陳德昌;馬麗瓊;;廣譜抗生素對膿毒癥大鼠腸道革蘭陰性桿菌的選擇作用[J];解放軍醫(yī)學(xué)雜志;2007年11期

3 宋曉晶;張棟;馬慧敏;王淑友;李順月;;電針對小鼠肝臟血流灌注量影響的激光散斑成像顯示[J];激光生物學(xué)報;2011年01期

4 陳德昌,李紅江,喬林,楊興易,景炳文;大黃對膿毒癥大鼠肝細(xì)胞線粒體內(nèi)氧自由基泄漏的影響[J];中華急診醫(yī)學(xué)雜志;2002年02期

5 張麗;李鵬程;倪松林;曾紹群;駱清銘;;超深低溫作用下大鼠腦血流變化的激光散斑成像監(jiān)測[J];生物物理學(xué)報;2006年04期

6 蘇昊;鄭啟新;駱清銘;;激光散斑成像技術(shù)監(jiān)測脊髓血流動力學(xué)的實驗研究[J];華中科技大學(xué)學(xué)報(醫(yī)學(xué)版);2009年01期

7 時兢,宋秀琴,謝衛(wèi)星,陸榮國,王燁,衡軍鋒;大黃對危重病患者胃腸功能衰竭的治療作用[J];現(xiàn)代診斷與治療;2004年01期

8 陳德昌,景炳文,楊興易,嚴(yán)鳴,李文放,許永華;大黃對創(chuàng)傷后危重病膿毒癥患者的治療作用[J];中華創(chuàng)傷雜志;2003年01期

9 陳德昌,姜興祿,李紅江,景炳文;大黃對危重癥患者胃腸粘膜血流灌注的影響[J];中國急救醫(yī)學(xué);1999年10期

10 李朗,孫俊,李明,葉錚;加溫灌注明膠墨汁制作動物腦血管模型的方法[J];中國臨床解剖學(xué)雜志;2004年02期

本文編號：2026158