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目的探讨急性前脑缺血致多器官功能障碍综合征(MODS)模型血清内毒素含量及其受体在各脏器基因表达的规律,分析脑原性多器官功能障碍综合征(CMODS)的发生机制。方法随机将54只Wistar大鼠分为正常对照组(6只)、假手术组(8只)和前脑缺血组(40只),后者又被随机分为12h、24h、36h、48h、和72h时相点的5个亚组,每亚组各8只;建立大鼠急性前脑缺血模型;分别采用偶氮显色法鲎试验定量法测定血清内毒素和原位杂交技术测定肺、肝、肠和肾组织CD14mRNA水平;使用CMIA真彩色医学图像分析系统,检测CD14mRNA的相对含量。结果大鼠急性前脑缺血后12h血清内毒素升高(0184±0055)Eu/L,24h达高峰(0639±0064)Eu/L,72h基本恢复至正常水平(0117±0024)Eu/L;肺、肝、肠和肾组织CD14mRNA的表达也在缺血后12h升高,24~36h达高峰,48h后下降,并以肺脏变化最显著(P<0001);正常对照组和假手术组CD14mRNA在各脏器均有不同程度的表达,其中两组肺脏的表达有显著性差异(P<001)。内毒素与其受体在各脏器的表达均存在显著相关性(均为P<001),其中与肠、肺组织CDmRNA表达相关最显著(P<0001)。结论急性前脑缺血致MODS大鼠存在内毒素血症;急性脑血管病→应激反应→肠道黏膜屏障损害→内毒素易位→内毒素血症→内脏器官功能障碍→MODS是CMODS发生的
Objective To investigate the changes of serum endotoxin content and the expression of its receptor in various organ tissues in acute multiple organ dysfunction syndrome (MODS) induced by forebrain ischemia and to analyze the occurrence of brain originated multiple organ dysfunction syndrome (CMODS) mechanism. Methods Fifty - four Wistar rats were randomly divided into normal control group (n = 6), sham operation group (n = 8) and forebrain ischemic group (n = 40). The latter group was randomly divided into 12h, 24h, 36h and 48h , And 5 subgroups at 72h phase, each subgroup was 8 rats. Acute forebrain ischemia model was established in rats. Azo chromogenic assay was used to determine the serum endotoxin and in situ hybridization Lung, liver, intestine and kidney CD14 mRNA levels; using CMIA true color medical image analysis system to detect the relative content of CD14 mRNA. Results The levels of endotoxin increased (0184 ± 0055) Eu / L at 12 h after acute forebrain ischemia in rats and reached the peak at 0639 ± 0064 and reached the peak at 0639 ± 0064, respectively, and returned to the normal level (0117 ± 0024) Eu / L at 72 h ; The expression of CD14 mRNA in lung, liver, intestine and kidney tissue also increased at 12h after ischemia, peaked at 24 ~ 36h, decreased after 48h, and the most significant change was in lung (P <0001). In normal control group and sham operation group The expression of CD14 mRNA in different organs was different, and the expression of CD14 mRNA in the two groups had significant difference (P <001). There was a significant correlation between endotoxin and its receptor expression in various organs (all P <001), which was the most significant correlation with CDmRNA expression in intestine and lung tissue (P <0001). Conclusion Acute forebrain ischemia has endotoxemia in MODS rats; acute cerebrovascular disease → stress reaction → intestinal mucosal barrier damage → endotoxin translocation → endotoxemia → visceral organ dysfunction → MODS is the occurrence of CMODS of