多器官功能障碍综合征时血管内皮细胞损伤的研究-中西医结合临床专业论文.docxVIP

— — PAGE 1— 摘 要 多器官功能障碍综合征时血管内皮细胞损伤的研究 研究生：李岩 导师：段绍斌 副教授 摘 要 目的：观察多器官功能障碍综合征（MODS）大鼠肺组织血管内皮细胞损伤以及 循环内皮细胞（CEC）、内皮素-1（ET-1）、一氧化氮（NO）和黏附分子等指标表达 变化，并探索它们之间的相互关系。方法：将SD大鼠72只随机分成对照组（不进行 休克处理），模型组，MODS组，采用失血性休克复合内毒素打击大鼠模型的实验方 法建立模型，复苏成功30min后，MODS组腹腔注射内毒素（2mg/kg）, 模型组注入 生理盐水（1ml/100g）。造模完成后各组大鼠自由饮食，分别在注射内毒素和生理盐 水后24h，36h，48h随机取3组大鼠各8只处死并采集肺组织标本和血液标本检测CEC、 ET-1、NO等指标。肺组织标本制备：大鼠处死后取肺组织标本先观察大体形态，取 左肺组织测定ICAM-1含量，并取右肺组织，镜下观察病理学变化。结果：肺组织病 理学改变镜下,对照组肺组织结构无明显损伤性组织学改变; 模型组、MODS组可见 肺间质及肺泡出血、水肿,炎性细胞大量聚集、浸润, 血细胞充满血管腔，肺泡腔内 上皮细胞改变；模型组组织学改变较MODS组轻。对照组和模型组3个时间点各指标 数量差异无统计学意义（P＞0.05）。模型组随时间延长各指标数量逐渐增加，组内差 异有统计学意义（P0.05）。MODS组随时间延长各指标数量逐渐增加，组内差异有 统计学意义（P0.05），组间比较3个时间点各指标数量的差异均有统计学意义 （P0.01）。结论：失血性休克和MODS时均有血管内皮细胞的损伤，MODS时更为 严重和明显，表现为CEC数量增多，同时有ICAM-1表达增高，NO和ET-1含量增高。 关键词：多器官衰竭综合症；循环内皮细胞；细胞间黏附因子-1；内皮素；一氧化氮 新疆医科大学医学硕士学位论文 The Study of Vascular Endothelial Cells Injury With Multiple Organ Dysfunction Syndrome Abstract Objective: To observation the endothelial cell injury of MODS rat lung , as well as expression of CEC, ET-1, NO and adhesion molecules such as indicators of Change ,and to explore the interrelationship between them. Methods: 72 will be SD rats were randomly divided into control group (no shock treatment), model group, MODS group, the use of composites in hemorrhagic shock rat model of endotoxin against experimental method set up model, after 30min of recovery success, MODS group with intraperitoneal injection endotoxin (2mg/kg), model group, normal saline injection (1ml/100g). Model after the completion of freely eating rats in each group, respectively, at injection of endotoxin and normal saline after 24h, 36h, 48h random check of the 3 groups of rats were killed and eight collecting lung tissue specimens and blood samples Detect CEC , ET-1, NO and so on. Preparation of lung tissues: Rats were sacrificed after the lung tissue samples to observe the general morphology, and determination of lung tissue from the left lung ICAM-1 of the content, and take right lung organizations