本文選題：膿毒癥 + TRPV1��； 參考：《皖南醫(yī)學(xué)院》2014年碩士論文

【摘要】：目的：膿毒癥是ICU急癥，臨床上發(fā)生率和死亡率都很高。近年來(lái)，人們發(fā)現(xiàn)膿毒癥往往會(huì)造成患者胃腸功能障礙，并認(rèn)為這種胃腸功能障礙在膿毒癥的發(fā)生發(fā)展中起到重要作用。大量研究證明TRPV1、CGRP在胃腸道表達(dá)廣泛，參與胃腸運(yùn)動(dòng)的調(diào)節(jié)。本次研究旨在觀察膿毒癥對(duì)腸動(dòng)力功能的影響，并探討TRPV1和CGRP在膿毒癥引起大鼠腸動(dòng)力改變中的作用。 方法：雄性清潔型SD大鼠20只,隨機(jī)分為2組,每組10只。A組:正常對(duì)照組;B組:膿毒癥組。禁食12h后，采用腹腔內(nèi)注射脂多糖(LPS)制備大鼠膿毒癥模型。每只大鼠腹腔注射LPS10mg/kg，LPS用生理鹽水稀釋成1ml，制成膿毒癥大鼠模型。正常對(duì)照組給于腹腔注射等量生理鹽水作為對(duì)照。造模結(jié)束繼續(xù)禁食,觀察12h，記錄血壓心率，后給與碳素墨汁灌胃，每只大鼠2ml。觀察20min后處死大鼠，剖腹取出大鼠胃及整個(gè)腸道，測(cè)定小腸墨汁推進(jìn)率，每只大鼠墨汁移行距離占小腸全長(zhǎng)的百分率即為小腸推進(jìn)率。并于距盲腸15cm處快速切取一段約3cm的空腸段制備標(biāo)本，備行TRPV1、CGRP免疫組織化學(xué)染色檢測(cè)，鏡下觀察比較各指標(biāo)兩組間的染色結(jié)果，將陽(yáng)性細(xì)胞百分率評(píng)分與染色強(qiáng)度評(píng)分的乘積作為最后的積分。采用SPSS18.0軟件包分析各組數(shù)據(jù)。 結(jié)果：腹腔注射內(nèi)毒素后大鼠的疾病狀態(tài)評(píng)分較正常組明顯上升，，心率加快，差異均有統(tǒng)計(jì)學(xué)意義。膿毒癥組大鼠的小腸墨汁推進(jìn)率明顯低于對(duì)照組，P0.05差異有統(tǒng)計(jì)學(xué)意義。免疫組織化學(xué)染色結(jié)果示，TRPV1、CGRP陽(yáng)性染色細(xì)胞可見(jiàn)于粘膜層、粘膜固有層等，表達(dá)較為廣泛，膿毒癥組中TRPV1、CGRP的陽(yáng)性細(xì)胞數(shù)與染色程度乘積的積分明顯高于對(duì)照組，P0.05，差異有統(tǒng)計(jì)學(xué)意義。 結(jié)論：1、腹腔注射內(nèi)毒素10mg/kg后可以建立理想的膿毒癥大鼠模型。2、膿毒癥組大鼠小腸推進(jìn)率較對(duì)照組顯著下降，可見(jiàn)膿毒癥大鼠發(fā)生明顯的腸道動(dòng)力障礙。3、膿毒癥時(shí)大鼠腸道動(dòng)力障礙可能與TRPV1受體表達(dá)上調(diào)有關(guān)，且CGRP的表達(dá)變化與TRPV1一致，故推測(cè)TRPV1引起腸道動(dòng)力障礙可能與CGRP的表達(dá)增高有關(guān)
[Abstract]:Objective: sepsis is an emergency in ICU with high incidence and mortality. In recent years, it has been found that sepsis often causes gastrointestinal dysfunction in patients, and this gastrointestinal dysfunction plays an important role in the occurrence and development of sepsis. A large number of studies have shown that TRPV1 CGRP is widely expressed in the gastrointestinal tract, involved in the regulation of gastrointestinal motility. The purpose of this study was to observe the effect of sepsis on intestinal motility and to explore the role of TRPV1 and CGRP in intestinal motility changes induced by sepsis in rats. Methods: twenty male clean Sprague-Dawley rats were randomly divided into two groups: group A (n = 10): normal control group (n = 10): sepsis group (n = 10). After fasting for 12 hours, the sepsis model of rats was established by intraperitoneal injection of lipopolysaccharide (LPS). Each rat was injected intraperitoneally with LPS 10 mg / kg LPS and diluted into 1 ml with normal saline to make sepsis rat model. The normal control group was given intraperitoneal injection of the same amount of normal saline as the control group. At the end of the model, the rats continued to fast, observed for 12 hours, recorded the blood pressure and heart rate, and then given carbon ink to the stomach, each rat 2 ml. After observation of 20min, the rats were sacrificed, the stomach and the whole intestine were taken out by laparotomy, and the rate of small intestinal ink propelling was determined. The percentage of the migration distance of each rat's ink to the whole intestine was the small intestinal propulsion rate. A section of jejunum about 3cm was quickly cut from the cecum 15cm to prepare the specimen, and the immunohistochemical staining of TRPV1 was performed. The results of the two groups were observed and compared under the microscope. The product of positive cell percentage score and staining intensity score was used as final score. The data of each group were analyzed by SPSS 18.0 software package. Results: after intraperitoneal injection of endotoxin, the scores of disease state and heart rate in rats were significantly higher than those in normal group. The promoting rate of small intestinal ink in sepsis group was significantly lower than that in control group (P0.05). The results of immunohistochemical staining showed that the positive staining cells of TRPV1 + CGRP could be seen in the mucosal layer, lamina propria of mucosa and so on. The number of CGRP positive cells in TRPV1 in sepsis group was significantly higher than that in control group (P 0.05). Conclusion the ideal sepsis rat model can be established by intraperitoneal injection of endotoxin 10mg/kg. The intestinal propulsion rate in sepsis group is significantly lower than that in control group. It can be seen that there are obvious intestinal motility disorders in sepsis rats. The intestinal motility disorder in septic rats may be related to the up-regulation of TRPV1 receptor, and the change of CGRP expression is consistent with that of TRPV1. It is speculated that the intestinal motility disorder caused by TRPV1 may be related to the increase of CGRP expression.
【學(xué)位授予單位】：皖南醫(yī)學(xué)院
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2014
【分類(lèi)號(hào)】：R459.7

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