本文選題：高壓氧治療 + 高能沖擊波��； 參考：《廣西醫(yī)科大學(xué)》2014年碩士論文

【摘要】：目的：通過高壓氧療（Hyperbaric oxygen therapeutics，HBOT）對高能沖擊波（High energy shock wave，HESW）致腎損傷的兔動物模型進(jìn)行干預(yù)，探討HBOT對HESW引起的腎損傷的治療效果及其可能的機制。 方法：30只健康雄性新西蘭大白兔，隨機分空白對照組（n=10）、模型對照組（n=10）、治療組（n=10）。模型對照組及治療組在B超引導(dǎo)下按12KV的電壓、60次/分鐘的頻率沖擊兔左腎中部2000次，建立HESW致腎損傷模型。治療組于建模后24h開始接受連續(xù)7天、每天1次HBOT。模型對照組建模后不予HBOT干預(yù)；空白對照組僅行備皮、麻醉，不予HESW或HBOT干預(yù)。于試驗前、沖擊后4h及HBOT后的24h、72h、7d的對應(yīng)時期經(jīng)耳中動脈采血，檢測血清SCR、BUN、ET-1、TNF-α、MDA、SOD。分別在試驗的4h、24h、72h采血后于各組隨機抽取一只白兔全麻下摘取雙腎、在試驗7d采血后全麻下摘取所有白兔的雙腎，作HE染色組織病理檢查。 結(jié)果：1．動物模型：成功建立新西蘭大白兔HESW腎損傷模型； 2．白兔體重：三組白兔組間比較均無差異（P＞0.05）；空白對照組試驗7d的體重大于試驗前（P＜0.05）; 3．血清學(xué)檢測結(jié)果： （1）SCR和BUN：三組白兔各時期組內(nèi)及組間比較均無差異（P＞0.05）; （2）ET-1、TNF-α及MDA：三組結(jié)果試驗前均無差異（P＞0.05）；模型對照組和治療組在4h、24h、72h的結(jié)果均高于空白對照組（P＜0.05），7d時則三組結(jié)果相仿（P＞0.05）；治療組24h、72h的結(jié)果均低于同時期模型對照組（P＜0.05）；組內(nèi)比較顯示，模型對照組和治療組的各檢測值在沖擊后呈上升趨勢（P＜0.05），7d時基本恢復(fù)到試驗前水平（P＞0.05）； （3）SOD：三組試驗前無差異（P＞0.05）；模型對照組和治療組4h、24h、72h的結(jié)果均低于空白對照組（P＜0.05），7d時三組結(jié)果相仿（P＞0.05）；治療組24h、72h的結(jié)果均高于同時期模型對照組（P＜0.05）；組內(nèi)比較顯示，模型對照組和治療組的SOD在沖擊后呈下降趨勢（P＜0.05），7d時基本恢復(fù)到試驗前水平（P＞0.05）； 4．HE染色組織病理檢查：空白對照組腎組織病理檢查未見異常；模型對照組及治療組腎臟均有不同程度腎小球腎小管結(jié)構(gòu)破壞和間質(zhì)充血出血、水腫、炎細(xì)胞浸潤、纖維化等改變，，而治療組的損傷程度輕于模型對照組；接受HESW處理白兔的右腎亦可見程度輕于左腎的腎間質(zhì)充血、細(xì)胞水腫、炎癥細(xì)胞浸潤等變化。 結(jié)論：1．高壓氧治療可通過減少自由基的生成、減輕脂質(zhì)過氧化、抑制過量炎癥因子及血管活性物質(zhì)的釋放等等多種作用機制，對高能沖擊波引起的腎臟損傷有著多方面的保護(hù)作用； 2. HESW沖擊正常兔的一側(cè)腎臟，其對側(cè)腎臟亦存在一定程度的損傷性改變，不宜選用自體腎臟作對照研究。
[Abstract]:Objective: to investigate the effect and possible mechanism of hyperbaric oxygen therapy (HBOT) on renal injury induced by high energy shock wave (HESW) in rabbits, and to explore the therapeutic effect of HBOT on renal injury induced by HESW. Methods 30 healthy male New Zealand white rabbits were randomly divided into control group (n = 10), model control group (n = 10) and treatment group (n = 10). The model control group and the treatment group were subjected to 60 times of 12KV voltage per minute and 2000 times to the middle of the left kidney under the guidance of B-ultrasound to establish the model of renal injury induced by HESW. The treatment group received HBOT once a day for 7 days at 24 h after modeling. The model control group did not intervene with HBOT after modeling, while the blank control group only received skin preparation, anesthesia and no HESW or HBOT intervention. The blood samples were collected from the middle ear artery before the experiment, 4 hours after shock and 24 hours after HBOT. The blood samples were collected from the middle ear artery to detect the serum SCRN BUNET-1 TNF- 偽 and MDA-SOD. Two kidneys were randomly selected from one white rabbit under general anesthesia after blood collection at 4 h and 24 h for 72 h in each group. After 7 days of blood collection, the two kidneys of all white rabbits were removed under general anesthesia for HE staining histopathological examination. The result is 1: 1. Animal model: HESW renal injury model was successfully established in New Zealand white rabbits. 2. The weight of white rabbits: there was no difference among the three groups (P > 0.05), the weight of the blank control group was higher than that of the control group on the 7th day (P < 0.05). 3. Serological results: There was no significant difference in SCR and bun among the three groups (P > 0.05). The results of TNF- 偽 and MDAin the model control group and the treatment group were higher than that of the blank control group at 24 h and 72 h, respectively, and the results of the treatment group were lower than those of the model control group at 24 h and 72 h respectively (P < 0.05), and the results of the treatment group at 24 h were lower than those of the control group at 24 h (P < 0.05), the results of the treatment group were lower than that of the control group at 24 h after the treatment (P < 0.05), and the results of the treatment group were higher than those of the control group (P < 0.05). The detection values of the model control group and the treatment group showed an upward trend after shock (P < 0.05) and returned to the pre-test level after 7 days (P > 0.05). The results of the model control group and the treatment group were lower than that of the blank control group (P < 0.05) and the results of the treatment group were higher than that of the model control group (P < 0.05) at 24 h or 72 h, the results of the treatment group were higher than that of the model control group (P < 0.05), and the results of the treatment group were higher than those of the control group (P < 0.05), and the results of the three groups were similar to those of the control group (P < 0.05) at 7d after the treatment, the results of the treatment group were higher than those of the model control group (P < 0.05). The SOD of the model control group and the treatment group showed a downward trend after shock (P < 0.05) and returned to the pre-test level after 7 days (P > 0.05). 4.HE staining histopathological examination: there was no abnormal renal histopathological examination in blank control group, glomerular tubular structure destruction and interstitial hyperemia hemorrhage, edema, inflammatory cell infiltration were found in model control group and treatment group. The degree of injury in the treatment group was less than that in the model control group, and the degree of interstitial congestion, cell edema and inflammatory cell infiltration in the right kidney treated with HESW was less than that in the left kidney. Conclusion 1. Hyperbaric oxygen therapy can reduce the production of free radicals, reduce lipid peroxidation, inhibit the release of excessive inflammatory factors and vasoactive substances, and have many protective effects on renal injury induced by high energy shock wave. 2. The contralateral kidney of HESW was damaged to some extent, so it was not suitable to choose autogenous kidney as a control study.
【學(xué)位授予單位】：廣西醫(yī)科大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2014
【分類號】：R692.5

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