ICU获得性衰弱模型大鼠细胞因子和骨骼肌病理结构的动态变化及意义  

Investigation on the dynamic changes and significance of cytokines and skeletal muscle pathological structure in rats with ICU-acquired weakness

作　　者：高宇 谭旭宏 胡永胜 Gao Yu;Tan Xuhong;Hu Yongsheng(The Second Clinical Medical College of Guizhou University of Traditional Chinese Medicine,Guiyang Guizhou 550001,China;Department of Critical Care Medicine,the Second Affiliated Hospital of Guizhou University of Traditional Chinese Medicine,Guiyang Guizhou 550001,China)

机构地区：[1]贵州中医药大学第二临床医学院,贵州贵阳550001 [2]贵州中医药大学第二附属医院重症医学科,贵州贵阳550001

出　　处：《遵义医科大学学报》2023年第10期934-942,共9页Journal of Zunyi Medical University

基　　金：贵州省科技计划项目[NO:黔科合支撑(2021)一般091];贵州省中医药、民族医药科学技术研究课题(NO:QZYY-2020-017)。

摘　　要：目的探讨ICU获得性衰弱(ICU-AW)模型大鼠细胞因子白细胞介素1β(IL-1β)、白细胞介素6(IL-6)、白细胞介素22(IL-22)及膈肌、腓肠肌病理结构的动态变化情况及意义。方法将SPF级SD雄性大鼠随机分为对照组、假手术组和模型组,模型组采用盲肠穿刺结扎法(CLP)造模,假手术组仅开腹盲肠探查,对照组正常饲养。定期观察并记录各组大鼠的外观表征及体重。分别于造模后第1、3、6天,留取血清、膈肌及腓肠肌标本,测算膈肌湿重、膈肌湿重/体重、腓肠肌湿重及腓肠肌湿重/体重,HE染色测算肌纤维横截面积(CSA),Masson染色测算胶原容积分数(CVF),酶联免疫吸附测定法(ELISA)检测血清、膈肌及腓肠肌组织中IL-1β、IL-6及IL-22的水平。结果与假手术组比较,模型组大鼠在造模后第1、3、6天体重、膈肌湿重、膈肌湿重/体重、腓肠肌湿重、腓肠肌湿重/体重及肌纤维CSA均显著减低(P<0.01),CVF显著增加(P<0.01),血清、膈肌及腓肠肌组织中IL-1β、IL-6及IL-22的水平均显著增加(P<0.01)。结论ICU-AW模型大鼠膈肌和腓肠肌出现肌萎缩,并随造模时间延长而加重,伴有血清、膈肌及腓肠肌组织中炎性细胞因子水平增加,提示ICU-AW的骨骼肌受损可能与炎性机制有关。Objective To investigate the dynamic changes and significance of cytokines interleukin-1β(IL-1β),interleukin-6(IL-6),interleukin-22(IL-22)and pathological structure of diaphragm and gastrocnemius in rats with intensive care unit acquired weakness(ICU-AW).Methods SPF male SD rats were randomly divided into control group,sham operation group and model group.The model group was established by cecal ligation and puncture(CLP),the sham operation group performed only open cecal exploration,and the control group was fed normally.The appearance and body weight of rats in each group were observed and recorded regularly.The serum,diaphragm and gastrocnemius samples were collected at 1st,3rd and 6th day after modeling.The diaphragm wet weight,diaphragm wet weight/body weight,gastrocnemius wet weight and gastrocnemius wet weight/body weight were measured,and the cross-sectional area(CSA)of muscle fiber was measured by HE staining.Masson staining was used to measure collagen volume fraction(CVF).Enzyme-linked imm unosorbent assay(ELISA)was used to measure the levels of IL-1β,IL-6 and IL-22 in serum,diaphragm and gastrocnemius.Results Compared with the sham operation group,the body weight,diaphragm wet weight,diaphragm wet weight/body weight,gastrocnemius wet weight,gastrocnemius wet weight/body weight and CSA of muscle fiber in the model group were significantly decreased(P<0.01),and CVF was significantly increased(P<0.01).On the 1st,3rd and 6th day after modeling,the levels of IL-1β,IL-6 and IL-22 in serum,diaphragm and gastrocnemius were significantly increased(P<0.01).Conclusion The diaphragm and gastrocnemius muscle in ICU-AW model rats showed muscle atrophy,which is aggravated with the extension of modeling time,accompanied by the increase of inflammatory cytokines in serum,diaphragm and gastrocnemius muscle tissue,suggesting that the damage of skeletal muscle in ICU-AW may be related to inflammatory mechanism.

关 键 词：ICU获得性衰弱 骨骼肌损伤 炎性细胞因子 盲肠穿刺结扎法 大鼠 

分 类 号：R363[医药卫生—病理学]