【摘要】：目的:通過設立大鼠SAP模型,探討不同海拔情況下SAP肺損害程度及肺組織中基質(zhì)金屬蛋白酶-9的表達,為了解高原低氧環(huán)境下SAP特殊臨床特征提供有效的參考。方法:以SPF級雄性Wistar大鼠為實驗對象并隨機分為西安組、西寧組、興海組、溫泉組四個海拔組,每組又各包含5個時間組:F組(假手術組)、SAP1h、6h、12h組和24h組。SAP組在大鼠胰腺被膜下注射牛黃膽酸鈉建立不同海拔地區(qū)大鼠SAP模型,假手術組開腹后僅輕柔翻動胰腺。各組分別于相應時間點采大鼠腹主動脈血、胰腺及肺臟組織。利用離心血清法檢測AMY,血氣分析儀檢測動脈血中PaO2、PaCO2、SaO2及pH值;胰腺病理評分;使用免疫組化法檢測MMP-9在肺臟組織中的表達情況。統(tǒng)計方法:使用SPSS 19.0統(tǒng)計學軟件對資料進行分析。實驗數(shù)據(jù)均以均數(shù)±標準差(x±s)表示。用單因素方差分析(one-way ANOVA)比較組內(nèi)差別;相關性分析用pearson相關或spearman秩相關分析。檢驗水準取α=0.05。結(jié)果:同一海拔下:各時間組隨著大鼠AP病程的延長AMY及胰腺病理學評分、肺臟中MMP-9的表達增高,差異有統(tǒng)計學意義(P0.01);血氣分析pH值、Pa O2、SaO2隨著胰腺炎病程時間的延長下降,PaCO2隨著胰腺炎病程延長而升高,差異有統(tǒng)計學意義(P0.01)。不同海拔情況下:同一時間組(F組除外)內(nèi)各海拔組,隨著海拔的增高,血淀粉酶及胰腺病理學評分、肺組織中MMP-9的表達增高,差異有統(tǒng)計學意義(P0.01);血氣分析pH值、PaO2、SaO2隨著海拔的升高而下降,PaCO2隨著海拔而升高,差異有統(tǒng)計學意義(P0.01);F組中SaO2隨著海拔的升高而降低,差異有統(tǒng)計學意義(P0.05),血氣分析pH值、PaO2、PaCO2、血淀粉酶及胰腺病理學評分、肺組織中MMP-9的表達隨海拔變化無明顯差異(P0.05)。結(jié)論:1、隨著海拔的升高胰腺損傷嚴重程度逐漸增加。2、隨著海拔的升高SAP肺損傷的嚴重程度逐漸增加。3、MMP-9參與了SAP肺損傷的過程,且MMP-9的表達隨著海拔及病程延長而增加。
[Abstract]:Objective: to investigate the degree of lung damage of SAP and the expression of matrix metalloproteinase-9 (MMP-9) in lung tissue of rats with SAP at different altitudes, so as to provide an effective reference for understanding the special clinical characteristics of SAP under high altitude hypoxia. Methods: SPF male Wistar rats were randomly divided into four groups: Xi'an group, Xining group, Xinghai group and hot spring group. Each group was divided into 5 groups: group 1: F (sham-operation group), SAP1h, 6h, 12h and 24h. Rats were injected with sodium bovine cholate under the pancreatic capsule to establish SAP model at different altitudes. The rats in sham-operation group were only slightly turned over after laparotomy. The abdominal aorta blood, pancreas and lung tissue were collected at the corresponding time points in each group. The values of PaO2,PaCO2,SaO2 and pH in arterial blood were detected by AMY, blood gas analyzer, the pancreatic pathological score and the expression of MMP-9 in lung tissue were detected by immunohistochemical method. Methods: SPSS 19.0 statistical software was used to analyze the data. The experimental data were expressed as mean 鹵standard deviation (x 鹵s). Univariate analysis of variance (one-way ANOVA) was used to compare intra-group differences, and pearson correlation or spearman rank correlation was used for correlation analysis. The test level is 偽 0. 05. Results: at the same altitude, the expression of MMP-9 in lung increased with the prolongation of the course of AP and the pancreatic pathological score in each time group. The difference was statistically significant (P0.01), the pH value of Pao _ 2SaO _ 2 decreased with the prolongation of the duration of pancreatitis and Paco _ 2 increased with the prolongation of the course of pancreatitis (P0.01). At different elevations, the expression of MMP-9 in lung tissues increased with the elevation, serum amylase and pancreatic pathological score in the same time group (except group F). The difference was statistically significant (P0.01), the pH value of Pao _ 2SaO _ 2 decreased with the increase of altitude, and Paco _ 2 increased with elevation, and the SaO2 in group F decreased with the increase of altitude. The difference was statistically significant (P0.05). There was no significant difference in the expression of MMP-9 in lung tissue with elevation (P0.05). The pH value of blood gas analysis was Pao _ 2 Paco _ 2, blood amylase and pancreatic pathological score. Conclusion the severity of pancreatic injury increases gradually with increasing altitude, and the severity of lung injury of SAP increases with elevation. MMP-9 is involved in the process of SAP lung injury, and the expression of MMP-9 increases with elevation and duration of disease.
【學位授予單位】：青海大學
【學位級別】：碩士
【學位授予年份】：2016
【分類號】：R576

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