胰岛素强化治疗对高血糖烫伤和创伤大鼠肝核转录因子κB的影响.DOCVIP

临床医学论文-胰岛素强化治疗对高血糖烫伤和创伤大鼠肝核转录因子κB的影响 ???????????????? 作者：张胜兰，张晓雷，寇伟，耿明，刘鹏?? 【摘要】? 目的 探讨胰岛素强化治疗对高血糖烫伤和创伤大鼠肝脏核转录因子κB（NF-κB）表达的影响。方法 60只Wistar雄性大鼠用链脲佐菌素腹腔注射诱发DM模型，随机分为烫伤强化治疗组（n=15）和烫伤常规治疗组（n=15）,创伤强化治疗组（n=15）和创伤常规治疗组（n=15）。强化治疗组将血糖控制在3.9～5.6mmol/L，常规治疗组将血糖控制在10～12mmol/L。于治疗后第10天活杀取肝右叶部分，4%多聚甲醛固定，切片，免疫组化观察NF-κB的表达。 结果 烫伤和创伤强化治疗组NF-κB表达显著低于烫伤和创伤常规治疗组（P0.05）。 结论 胰岛素强化治疗组NF-κB表达显著低于常规治疗组，显示胰岛素强化治疗与常规血糖控制相比能更好地抑制炎症反应，发挥机体保护作用。 【关键词】? 高血糖大鼠；胰岛素强化治疗；烫伤和创伤；核转录因子κB；肝脏 ??? 【Abstract】? Objective? To? investigate? the effect? of? insulin? intensive? threapy? on? NF-κB? expression? in? the? livers? of hyperglycemic scald and? trauma? rats .? Methods? 60? male? Wistar? rats were? received? intraperitoneal? injection? of? streptozotocin? to? establish? diabetic? model.? Then?they?were?randomized?into?4?groups:scald?intensive?therapy?group(n=15) and scald conventional?therapy?group(n=15). trauma?intensive?therapy?group(n=15) and trauma conventional?therapy?group(n=15).?Blood?glucose?was?maitained?at?the? level? of? 3.9～5.6mmol/L? in? the? intensive therapy? group ,and? 10～12mmol/L? in? the? conventional? therapy? group. At? the 10th? day? after? therapy ,the? livers? were? collected,? then? the? expression? of? NF-κB? was? observed? by? immunohistochmistry.Results? The? expression? of? NF-κB? in scald and trauma? intensive? therapy? group? was? significantly? lower? than? that? in? the? conventional? therapy? group(P0.05).Conclusion? The? expression? of? NF-κB? in scald and trauma? intensive? therapy? group? was? significantly? lower? than? that? in? the? conventional? therapy? group,? which? suggest? that? insulin? intensive? therapy? can? inhibit? inflammatory? response? better? than? conventional? therapy,? and? exert? protection? to? the? body. ??? 【Key words】? hyperglycemic? rats;insulin? intensive? therapy; scald and trauma;? nuclear? transcription factor-κB;? liver ??? 近年的研究已证明，糖尿病患者发生危重症的频率和需要手术干预的机会都比非糖尿病患者要多［1］，而国外在糖尿病危重症的抢救中［1，2］，胰岛素强化治疗较常规治疗可提高其抢救成功率