脓毒症小鼠心功能不全与Toll样受体4表达的研究  

Toll -like receptor 4 and cardiac dysfunction during sepsis in mouse model

作　　者：周丹[1] 章鸣[1] 欧阳敏稚[1] 唐逵 

机构地区：[1]湖南长沙中南大学湘雅二医院超声科,410011

出　　处：《中国急救医学》2016年第10期880-883,共4页Chinese Journal of Critical Care Medicine

基　　金：国家自然科学基金青年科学基金项目（81201096）

摘　　要：目的探讨应变率分析是否能够敏感、准确地评价脓毒症所致心功能不全，观察脓毒症所致心功能不全心肌组织Toll样受体4mRNA（TLR4mRNA）的表达。方法盲肠结扎穿孔法（CLP）建立小鼠脓毒症模型。小鼠分为假手术组（Sham，n=20）和脓毒症组（CLP，n=32）。Sham组与CLP组分别观察小鼠的存活情况至术后7d，于术后24h行离体心脏灌流术。Sham组与CLP组在术前及术后各个时间点行超声心动图，术后采集心脏组织标本。qRT—PCR检测心肌组织TLR4mRNA的表达。结果术后CLP组小鼠96h死亡率约80％，而Sham组无死亡（P〈0．05）。超声心动图显示，CLP组较Sham组12、24h心功能有轻度下降，左室舒张末期内径略有扩张（P〉0．05），而左室后壁应变率明显下降（P〈0．05）。离体心脏灌流法显示，CLP组较Sham组心功能明显降低（P〈0．05）。术后cLP组心肌TLR4tuRNA的表达与Sham组比较12h即开始升高，24h仍明显升高（P〈0．05）。结论脓毒症心肌组织内TLR4mRNA的高表达可能与脓毒症心功能障碍有关，心肌应变率分析是评价脓毒症所致心功能不全的早期敏感指标。Objective The purpose of the study is to demonstrate that whether strain rate analysis can sensitively and accurately assess septic cardiac dysfunction in mouse model and the expression of Toll - like receptor 4 （ TLR4 ） mRNA in myocardial tissues. Methods Cecum ligation and puncture （CLP） method was used to induce sepsis in mice. All mice were divided into Sham（ n = 20） and CLP（ n = 32） surgery groups. Mortality was observed every 24 hours for up to 7 days. Left ventricular（LV） function was assessed in a Langendorff perfusion system 24 hours after CLP, dP/dt max, -dP/dt max, LVDP was recorded or calculated. Transthoracic echocardiographic images were obtained before and again at 12 h and 24 h after CLP. TLR4 mRNA expression in myocardial tissue was examined at 12 h and 24 h after CLP. Results After operation, the death rate of the CLP group within 96 hours was approximately 80% while there was no death in the sham group. Echocardiograph demonstrated that after CLP operation the cardiac function of mouse in sham group declined slightly within 12 and 24 hours（ P 〉 0.05 ）. Strain rate analysis showed the SR of the LV posterior wall of mouse with sepsis declined evidently （P 〈 0.05）. Heart perfusion in vitro after CLP showed that compared with sham group, the heart function of the mouse with sepsis fell down obviously（P 〈0.05 ）. The qRT- PCR results showed that after CLP, TLR4 mRNA in myocardial tissues began to rise within 12 h and continued to increase when it reached 24 hours （ P 〈 0.05 ）. Conclusion Strain rate can sensitively assess septic cardiac dysfunction. The expression of TLR4 mRNA in myocardial tissue is related to the cardiac dysfunction induced by sepsis.

关 键 词：TOLL样受体4 脓毒症 心功能不全 应变率成像 

分 类 号：R392.3[医药卫生—免疫学]