不同目标血糖水平对脓毒症大鼠肿瘤坏死因子和内皮细胞特异性分子-1表达的影响  

Effect of target glucose control therapy on expression of tumor necrosis factor-α and endothelial cell specific molecule-1 for rats with sepsis

作　　者：朱桂云[1] 程青虹[1] 何永来[1] 李瑞瑞[1] 

机构地区：[1]新疆石河子大学医学院第一附属医院,石河子832008

出　　处：《内科急危重症杂志》2014年第1期54-56,共3页Journal of Critical Care In Internal Medicine

摘　　要：目的：探讨胰岛素控制不同目标血糖水平对脓毒症大鼠肿瘤坏死因子（TNF-α）、内皮细胞特异性分子（ESM-1）表达的影响以及对肺损伤的作用。方法：40只SD大鼠随机分为5组：假手术组（Sham组）、脓毒症组及血糖控制A组（4.4~6.1 mmol/L）、B组（6.2-8.3 mmol/L）、C组（8.4-10.0 mmol/L）,各8只。盲肠结扎穿孔术后12 h处死,双抗夹心ELISA法检测血清TNF-α、ESM-1水平,光镜观察肺组织病理切片。结果：脓毒症组血清TNF-α、ESM-1的表达明显高于Sham组及各血糖控制组（均P〈0.05）。A组较B组和C组TNF-α、ESM-1的表达明显降低（均P〈0.05）;B组低于C组（P〈0.05）。肺病理组织损伤评分脓毒症组均明显高于sham组及各控制组（均P〈0.05）,A组较B组和C组明显降低（均P〈0.05）。结论：与6.2~8.3 mmol/L及8.4-10.0 mmol/L比较,血糖控制在4.4-6.1 mmol/L明显降低血中TNF-α、ESM-1的表达,且对脓毒症大鼠肺损伤保护作用最明显。Objective： To explore the effect of target glucose control therapy on the expression of tumor necrosis factor-α（ TNF-α） and endothelial cell specific molecule-1（ ESM-1） and its effect on lung injury for rats with sepsis. Methods： Forty Sprague-Dawley rats were randomly divided into five groups： sham operation group（ sham group）,sepsis group（ group CLP）,glycemic control A group（ 4. 4 ~6. 1 mmol/L）,glycemic control B group（ 6. 2 ~8. 3 mmol/L） and glycemic control C group（ 8. 4 ~ 10. 0 mmol / L）,eight rats for each group. The sepsis model of rat was established by cecal ligation and puncture（ CLP）,and the models were sacrificed 12 hours after CLP. Serum levels of TNF-α and ESM-1 were detected by enzyme-linked immunosorbent assay（ ELISA）,the pathological changes of lung tissue was observed by optical microscope. Results： The expressions of TNF-α and ESM-1 in sepsis groups were higher than those in sham group and all glycemic control groups（ P〈0. 05）. They were significantly decreased in group A than those in group B and C（ P〈0. 05）,and they were lower in group B than those in group C（ P〈0. 05）. The pathology tissue injury score was significantly higher in sepsis group than those in sham group and all glycemic control groups（ P〈0. 05）,and the lung pathology tissue injury score was significantly lower in group A（ P〈0. 05）. Conclusion： Compared with glycemic control B group and C group,target glucose control management at 4. 6 ~ 6. 1 mmol / L can reduce the levls of TNF-α and ESM-1,and could significantly alleviate acute lung injury.

关 键 词：脓毒症 目标血糖控制 肿瘤坏死因子-Α 内皮细胞特异性分子-1 

分 类 号：R515.3[医药卫生—内科学]