不同盲肠结扎穿孔术模型对病死率与调节性T细胞比例的影响研究  

Influence of cecal ligation and puncture models on mortality rate and proportion of regulatory T cells of patients

作　　者：孙成栋[1] 张淑文[2] 李真[1] 王燕[1] 白爱华[1] 

机构地区：[1]北京积水潭医院感染疾病科,北京100035 [2]首都医科大学附属北京友谊医院感染内科,北京100050

出　　处：《中华医院感染学杂志》2016年第10期2302-2304,共3页Chinese Journal of Nosocomiology

基　　金：北京市科技计划重大基金资助项目(京科技发2002-611)

摘　　要：目的研究不同盲肠结扎穿孔术（CLP）模型对病死率、内毒素及调节性T细胞比例（Treg%）的影响,为脓毒症试验造模严重程度提供依据。方法选取体质量为250~300g雄性SD大鼠90只,按模型制作过程中不同结扎部位及结扎的完整性分成6组,完全结扎1组（结扎盲肠1/3）、完全结扎2组（结扎盲肠1/2）、完全结扎3组（结扎盲肠全部）,不完全结扎1组（结扎盲肠1/3）、不完全结扎2组（结扎盲肠1/2）、不完全结扎3组（结扎盲肠全部）每组各15只,记录术后6、24、72h大鼠死亡率,采用流式细胞仪分析不同组别CLP大鼠血调节性T细胞比例变化;采用SPSSl8.0软件进行统计分析。结果完全结扎3组及不完全结扎3组大鼠6h与24h死亡率比较差异无统计学意义,72h死亡率明显随着结扎的长度增加、不完全结扎死亡率明显升高（P〈0.05）;不同组别的内毒素均升高,升高的程度随着结扎的部位的加长而明显增加（P〈0.01）,不完全结扎3组别的内毒素含量明显高于其他组别（P〈0.05）,不同组别的Treg%在72h明显升高（P〈0.01）,差异均有统计学意义,说明有细菌不断进入腹腔导致炎症的级联放大,免疫功能处于一种抑制状态。结论根据不同实验要求的死亡率可选用不同的CLP模型,Treg%水平是估计死亡率与疾病严重程度的良好指标。OBJECTIVE To observe the influence of different models of cecal ligation and puncture（CLP）on mortality rate,endotoxin,and proportion of regulatory T cells（Treg%）so as to provide guidance for building severity model for sepsis experiment.METHODS A total of 90 male SD rats with the body mass varying from 250 to 300g were enrolled in the study and divided into 6groups according to the ligation parts and the integrity of the ligation：the complete ligation group 1（1/3ligation of cecum）,the complete ligation group 2（1/2ligation of cecum）,the complete ligation group 3（whole ligation of cecum）,the incomplete ligation group 1（1/3ligation of cecum）,the incomplete ligation group 2（1/2ligation of cecum）,the incomplete ligation group 3（whole ligation of cecum）,with 15 rats in each group.The mortality rates of the rats were respectively recorded at 6,24,and 72 hours after surgeries,the proportion of blood regulatory T cells in different groups of CLP rats was analyzed by using flow cytometry,and the statistical analysis was performed with the use of SPSS18.0software.RESULTS There was no significant difference in the mortality rate of the rats between the incomplete ligation group 3and the complete ligation group 3at 6or 24 hours.The mortality rate was remarkably increased with the length of ligation at72 hours,and the mortality rate of the rats with incomplete ligation was significantly increased（P〈0.05）.The endotoxin level was elevated in all of the groups,and the elevated degree was significantly increased with the length of ligated site（P〈0.01）.The concentration of endotoxin of the incomplete ligation group 3was significantly higher than that of other groups（P〈0.05）.The Treg% was remarkably increased at 72hours（P〈0.01）,the difference was significant,indicating that bacteria continuously invaded into the abdominal cavity and result in cascade amplification of inflammation and that the immune function was in a state of inhibition.CONCLUSION The CLP model should be chos

关 键 词：脓毒症 盲肠结扎穿孔 死亡率 内毒素 

分 类 号：R574.61[医药卫生—消化系统]