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目的 观察油酸/脂多糖(OA/LPS)致伤的老年大鼠多器官功能障碍综合征(MODSE)主要脏器组织Toll样受体4(TLR4)mRNA表达变化,探讨TLR4在MODSE发生中的作用。方法 80只SD大鼠分为老年组及青年组,予以油酸(OA ,0 2 5ml/kg)和脂多糖(LPS ,3 5mg/kg)分次静脉注射(间隔4h) ,建立二次打击MODSE和青年MODS模型。观察对照组及伤后2、6、2 4h ,重要器官(肺、心、肝、肾)病理及功能的变化,分别检测肺、心、肝和肾组织中TLR4mRNA表达变化。结果 OA/LPS致伤后,肺脏损害出现最早,PaO2 于2h降至最低值,而心、肝、肾功能损害指标于6h达峰值。在同一时相点,老年鼠脏器损害重于青年鼠(P <0 0 5 ,P <0 0 1)。致伤后肺、心、肝和肾组织中TLR4mRNA表达均显著升高(P <0 0 5 ,P <0 0 1) ;其中以肺组织中最高,升高幅度最大,于2h达峰值;心、肝、肾组织中于6h达峰值。在相同时相点老年鼠各组织中TLR4mRNA表达高于青年鼠(P <0 0 5 ,P <0 0 1)。结论 油酸+脂多糖所致老年鼠多器官功能障碍重于青年鼠,以肺损伤出现最早,损伤最重。致伤后大鼠肺、心、肝、肾组织中TLR4mRNA表达升高,老年组高于青年组,以肺组织中最高,升高幅度最大,在MODSE发病机制中起重要作用,可能是MODSE发生过程中肺脏最先且严重受损的原因之一。
Objective To observe the changes of Toll-like receptor 4 (TLR4) mRNA expression in major organs of multiple organ dysfunction syndrome (MODSE) induced by oleic acid / lipopolysaccharide (OA / LPS) in senile rats and to explore the role of TLR4 in MODSE effect. Methods Eighty SD rats were divided into the elderly group and the young group. The rats were given intravenous injection of oleic acid (025ml / kg) and lipopolysaccharide (LPS, 35mg / kg) MODSE and youth MODS model. The changes of pathology and function of vital organs (lung, heart, liver, kidney) at 2, 6, 24 h after injury were observed and the changes of TLR4 mRNA expression in lung, heart, liver and kidney were detected. Results After the injury of OA / LPS, lung damage occurred most early, PaO2 decreased to the lowest value at 2h, and the indexes of heart, liver and kidney damage peaked at 6h. At the same time point, organ damage in aged mice was more severe than in young mice (P <0.05, P <0.01). The expression of TLR4 mRNA in lung, heart, liver and kidney tissue were significantly increased after injury (P <0.05, P <0.01), among which the highest and the highest increase in lung tissue reached the peak at 2h; heart , Liver, kidney tissue peaked at 6h. The expression of TLR4 mRNA in the aged mice was higher than that in the young mice at the same time point (P <0.05, P <0.01). Conclusion The multi-organ dysfunction in old mice induced by oleic acid + lipopolysaccharide is heavier than that in young mice, with the earliest lung injury and the most severe injury. The expression of TLR4mRNA in the lung, heart, liver and kidney tissue of rats after injury was higher than that of the young group, the highest and the highest increase in the lung tissue, which play an important role in the pathogenesis of MODSE, which may be caused by MODSE One of the reasons the lungs were first and severely damaged during the procedure.