维生素D对脓毒症大鼠血清血管性血友病因子血管性血友病因子裂解蛋白酶表达的影响  

The effect of vitamin D on the expression of serum vWF and ADAMTS13 in sepsis rat model

作　　者：徐俊 杨家来 陈剑[3] 程立顺 杨静 孟令毅 俞凤[2] 张泓[2] 

机构地区：[1]安徽医科大学第三附属医院合肥市第一人民医院急诊科,安徽合肥230001 [2]安徽医科大学第一附属医院急诊科,安徽合肥230032 [3]安徽省立医院南区重症医学科,安徽合肥230036

出　　处：《中国急救医学》2015年第12期1079-1082,I0009,共5页Chinese Journal of Critical Care Medicine

基　　金：基金项目：安徽医科大学校科学研究基金（2011xkj083）;2010年卫生系统合肥市科研计划项目第11号项目

摘　　要：目的观察维生素D（VD）对脓毒症大鼠血清血管性血友病因子（vWF）、血管性血友病因子裂解蛋白酶（ADAMTS13）表达的影响。方法采用腹腔注射内毒素的方法制备脓毒症大鼠模型，随机分为五组：正常对照组、脓毒症组、骨化三醇组（分别给予骨化三醇1mg／kg、5mg／kg、25mg／kg），观察大鼠一般情况，肺组织病理及肺湿／干质量比变化，血小板计数变化，血清vWF、ADAMTS13变化。结果脓毒症组大鼠病态表现明显，骨化三醇组病态表现优于脓毒症组，骨化三醇各组肺组织病理改变较脓毒症组明显减轻；脓毒症组及骨化三醇组（1mg／kg、5mg／ks）血小板计数低于正常对照组，骨化三醇组（25mg／ks）血小板计数与正常对照组比较差异无统计学意义，但低于脓毒症组；脓毒症组血清vWF较正常组显著增高，骨化三醇各组较正常组亦显著增高，但低于脓毒症组；脓毒症组及骨化三醇各组血清ADAMTSl3水平较正常对照组显著下降，骨化三醇各组血清ADAMTS13水平与脓毒症组比较差异无统计学意义。结论VD抑制vWF表达，改善内皮细胞损伤进而影响脓毒症发病进程，而这一作用并不是通过提高ADAMTS13的表达实现。脓毒症发生时循环中血小板降低主要与内皮细胞损伤、vWF增加有关。Objective To observe the effect of vitamin D（VD） on the expression of serum van Willebrand factor（vWF） and adisintegrin- like and metalloproteinase with thrombospand in type- 1 domain 13 （ADAMTS13） in sepsis rat model. Methods Sepsis rat model was prepared by intraperitoneal injection of lipopolysaccharide method, and randomly divided to 5 groups： normal control group, sepsis group and calcitriol group （which were treated with calcitriol 1 mg/kg, 5 mg/kg, 25 mg/kg）. The general conditionof rats was recorded, and lung pathology, lung wet/dry weight ratio, the platelet count, serum vWF and ADAMTS13 were determined. Results The pathological changes of rats in the sepsis group were obvious, and the pathological features of the calcitriol group were better than those of the sepsis group, and the pathological changes of the lung tissues of the calcitriol groups were significantly alleviated compared with the sepsis group. The platelet count in the sepsis group and the calcitriol groups（ 1 mg/kg, 5 mg/kg）was significantly lower than that in the normal control group, while the platelet count in the calcitriol group（25 mg/kg）was not significantly different than that in the normalcontrol group, but it was still significantly lower than that in the sepsis group. The serum levels of vWF in the sepsis group were signifieantly higher than those in the normal group, and the serum vWF in calcitriol groups was significantly higher than that in the normal group, but lower than that in the sepsis group. The serum levels of ADAMTS13 in the sepsis group and the calcitriol groups had no significant difference between each other, but they were decreased significantly compared with the normal control. Conclusion VD inhibits the expression of vWF and improves the endothelial cells damage, which could ＇affect the pathogenesis of sepsis, and this effect is not achieved by improving the expression of ADAMTS13. The decrease of circulation platelets in sepsis is mainly related to the injury of endothelial cells and

关 键 词：脓毒症 血管性血友病因子裂解蛋白酶(ADAMTS13) 维生素D(VD) 血管性血友病因子(vWF) 

分 类 号：R364.15[医药卫生—病理学]