本文選題：HBO + 抗蛇毒血清��； 參考：《遵義醫(yī)學(xué)院》2017年碩士論文

【摘要】：目的:通過五步蛇毒中毒大鼠模型,觀察五步蛇毒中毒后腎組織的病理變化過程,并探討HBO輔助抗蛇毒血清治療對五步蛇毒中毒大鼠腎的保護(hù)作用。方法:將96只健康成年雄性SD大鼠隨機分為空白對照組、蛇毒中毒組、血清治療組、血清+HBO治療組,每組24只。經(jīng)尾靜脈注射五步蛇蛇毒建立中毒模型,血清治療組于建模成功后即從尾靜脈注射抗蛇毒血清,血清+HBO治療組于注射抗蛇毒血清后0 h、4 h、11 h、23 h予以HBO治療一次,空白對照組不予任何處理。各組部分大鼠于注毒后1 h、5 h、12 h、24 h經(jīng)腹主動脈采血用于檢測凝血功能、腎功能、血清MDA和SOD,另部分大鼠用生理鹽水及多聚甲醛經(jīng)左心室灌注固定腎組織,并取右腎組織行HE染色觀察病理變化。結(jié)果:(1)中毒后大鼠的表現(xiàn):中毒大鼠出現(xiàn)煩躁、豎毛、活動及進(jìn)食水減少、皮膚內(nèi)臟出血、血尿等,腎臟肉眼觀察有明顯充血。(2)腎組織病理改變:蛇毒中毒大鼠出現(xiàn)腎小球出血、腎小囊擴張,周圍毛細(xì)血管存在不同程度的充血,腎小管管腔擴張,可見細(xì)胞低平,刷狀緣脫落,腎小管上皮細(xì)胞空泡化,腎間質(zhì)組織炎性細(xì)胞浸潤。隨著時間的推移腎出血減少,炎性細(xì)胞浸潤增加。以上病變在抗蛇毒血清治療后顯著改善,在血清+HBO治療后1h、5h改善較單純蛇毒血清治療明顯。(3)腎功能結(jié)果:與空白對照組比較,蛇毒中毒組各時間點的血Cr顯著升高(P0.05)。與蛇毒中毒組比較血清治療組、血清+HBO治療組在1 h血Cr值顯著降低(P0.05),其中血清+HBO治療組血Cr值明顯低于血清治療組(P0.05)。(4)凝血功能結(jié)果:與空白對照組比較,蛇毒中毒組各時間點的APTT、PT顯著升高(P0.05)。與蛇毒中毒組比較,血清治療組、血清+HBO治療組APTT值均明顯降低。在注毒1h、5h血清+HBO治療組APTT值又明顯低于血清治療組(P0.05)。PT值血清治療組、血清+HBO治療組各時間點比較無差異(P0.05)。與空白對照組比較,蛇毒中毒組FIB于注毒后1 h明顯降低(P0.05),予以血清、血清+HBO治療后明顯上調(diào),但血清治療組、血清+HBO治療組兩組間無差異。(5)血清MDA、SOD結(jié)果:蛇毒中毒組各時間點MDA值顯著高于空白對照組(P0.05)。血清治療組各時間點MDA值較蛇毒中毒組下降(P0.05),血清+HBO治療組較單純血清治療組1 h、5h下降(P0.05)。血清治療組SOD值1 h、5 h較蛇毒中毒組明顯上調(diào)(P0.05),血清+HBO治療組各時間點較蛇毒中毒組明顯上調(diào)(P0.05),血清+HBO治療組1h較血清治療組明顯上調(diào)(P0.05)。結(jié)論:(1)五步蛇毒中毒可導(dǎo)致大鼠腎損傷。(2)HBO輔助抗蛇毒血清治療對五步蛇中毒大鼠腎損傷有保護(hù)作用,越早采用其保護(hù)效應(yīng)越佳。
[Abstract]:Objective: to observe the pathological changes of renal tissue in rats with serpentine venom poisoning and to explore the protective effect of HBO on the kidney of rats poisoned by APV venom. Methods: 96 healthy male Sprague-Dawley rats were randomly divided into control group, snake venom poisoning group, serum treatment group and serum HBO treatment group with 24 rats in each group. The poisoning model was established by injecting snake venom into the tail vein. The serum treated group was injected with antivenom serum from the tail vein immediately after the model was successfully established, and the serum HBO group was treated with HBO once at 0 h after injection of antivenom serum for 11 h and 23 h after the injection of antivenom serum. Blank control group was not treated. Blood samples were collected from abdominal aorta at 1 h, 5 h, 12 h and 24 h after injection to detect coagulation function, renal function, serum MDA and SOD, while some rats were perfused with normal saline and polyformaldehyde to fix renal tissue through left ventricle. The pathological changes of the right kidney were observed by HE staining. Results the manifestations of rats after poisoning: irritability, bristling, decreased activity and feeding water, skin and visceral hemorrhage, hematuria, etc. The pathological changes of renal tissue were as follows: glomerular hemorrhage, renal capsule dilatation, peripheral capillary congestion, tubule dilatation, low level cells and brush edge abscission were observed in rats with snake venom poisoning. Tubular epithelial cells vacuolated and interstitial inflammatory cells infiltrated. Over time, renal bleeding decreased and inflammatory cell infiltration increased. The above pathological changes were significantly improved after antivenom serum treatment, and the renal function was significantly improved at 1 hour after serum HBO treatment than that by serovenom treatment alone. Results: compared with the blank control group, the serum Cr of snake venom poisoning group was significantly higher than that of the control group at each time point (P 0.05). Compared with snake venom poisoning group, serum HBO treatment group significantly decreased serum Cr value at 1 h, and serum HBO treatment group had lower serum Cr value than serum-treated group (P0.05P0.05U. 4) coagulation function: compared with blank control group, serum HBO treatment group had significantly lower blood Cr value than that of blank control group. APTTT in snake venom poisoning group was significantly higher than that in control group (P 0.05). Compared with snake venom poisoning group, the APTT value of serum treatment group and serum HBO group were significantly decreased. The value of APTT in the serum HBO treatment group was significantly lower than that in the serum treatment group at 1 hour or 5 h after injection of toxin, and the serum HBO value in the serum treatment group was significantly lower than that in the serum treatment group. There was no difference between the serum HBO treatment group and the serum HBO treatment group at different time points (P 0.05). Compared with the blank control group, the FIB in the snake venom poisoning group decreased significantly at 1 hour after the injection of the drug. The serum and serum HBO were significantly up-regulated, but in the serum treatment group, there was no significant difference between the two groups. There was no difference between the two groups in serum HBO. The results of serum MDA-SOD: the MDA value of snake venom poisoning group was significantly higher than that of the blank control group at each time point (P 0.05). The MDA value of serum treatment group was lower than that of snake venom poisoning group at each time point (P0.05A), and the serum HBO group was lower than that of serum-treated group (1 h, 5h). Compared with snake venom poisoning group, the SOD value of serum treatment group was significantly higher than that of snake venom poisoning group for 1 h, the serum HBO group was significantly higher than that of snake venom poisoning group at each time point, and the serum HBO treatment group was significantly up-regulated P0.05N at 1 hour compared with serum treatment group. Conclusion (1) Viper venom poisoning can induce renal injury in rats. HBO combined with anti-snake venom serum therapy has protective effect on renal injury of rats. The earlier it is used, the better the protective effect is.
【學(xué)位授予單位】：遵義醫(yī)學(xué)院
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2017
【分類號】：R646

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